Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2017 Aug 3;12(8):e0182488.
doi: 10.1371/journal.pone.0182488. eCollection 2017.

Comparison of glyburide and insulin in the management of gestational diabetes: A meta-analysis

Rongjing Song  1 , Ling Chen  2 , Yue Chen  1 , Xia Si  1 , Yi Liu  1 , Yue Liu  1 , David M Irwin  3   4 , Wanyu Feng  1
Affiliations
Meta-Analysis

Comparison of glyburide and insulin in the management of gestational diabetes: A meta-analysis

Rongjing Song et al. PLoS One. .

Abstract

Objective: The aim of this meta-analysis was to determine the efficacy and safety of glyburide as a treatment for gestational diabetes mellitus (GDM) compared to insulin.

Methods: A meta-analysis was conducted to compare the management of gestational diabetes with glyburide and insulin. Studies fulfilling all of the following inclusion criteria were included in this meta-analysis: subjects were women with gestational diabetes requiring drug treatment; the comparison treatment included glyburide vs insulin; one or more outcomes (maternal or neonatal) should be provided in the individual study; the study design should be a randomized control trial. Exclusion criteria: non-RCT studies; non-human data. PubMed, Embase and CENTRAL databases were searched from inception until 10 October 2016.

Results: Ten randomized control trials involving 1194 participants met the inclusion criteria and were included. 13 primary outcomes (6 maternal, 7 neonatal) and 26 secondary outcomes (9 maternal, 17 neonatal) were detected and analyzed in this study. Glyburide significantly increased the risk of any neonatal hypoglycemia [risk ratio (RR), 1.89; 95% confidence interval (95%CI), 1.26 to 2.82; p = 0.002]. Sensitivity analysis confirmed robustness of this result [RR, 2.29; 95%CI, 1.49 to 3.54; p = 0.0002]. No differences were observed between the two groups with respect to birth weights [mean difference (MD), 79; 95%CI, -64 to 221.99; p = 0.28] and the risk of macrosomia [RR, 1.69; 95%CI, 0.57 to 5.08; p = 0.35].

Conclusion: For women with gestational diabetes, no differences in maternal short term outcomes were observed in those treated with glyburide or insulin. However, the incidence of neonatal hypoglycemia was higher in the glyburide group compared to the insulin group.

PubMed Disclaimer

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Study selection flowchart.
Fig 2
Fig 2. Risk of bias of studies comparing glyburide and insulin.
Fig 3
Fig 3. Risk of bias summary of studies comparing glyburide and insulin.
Fig 4
Fig 4. Maternal outcomes comparing glyburide and insulin.
Fig 5
Fig 5. Neonatal outcomes comparing glyburide and insulin.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Dhulkotia JS, Ola B, Fraser R, Farrell T. Oral hypoglycemic agents vs insulin in management of gestational diabetes: a systematic review and metaanalysis. Am J Obstet Gynecol. 2010;203(5):457.e1–9. - PubMed
    1. American Diabetes Association. Erratum. Classification and diagnosis of diabetes. Sec. 2. In Standards of Medical Care in Diabetes-2016. Diabetes Care 2016;39(Suppl. 1):S13-S22. Diabetes care. 2016;39(9):1653 doi: 10.2337/dc16-er09 - DOI - PubMed
    1. Gupta Y, Kalra B, Baruah MP, Singla R, Kalra S. Updated guidelines on screening for gestational diabetes. Int J Womens Health. 2015;7:539–50. doi: 10.2147/IJWH.S82046 - DOI - PMC - PubMed
    1. de Seymour J, Chia A, Colega M, Jones B, McKenzie E, Shirong C, et al. Maternal Dietary Patterns and Gestational Diabetes Mellitus in a Multi-Ethnic Asian Cohort: The GUSTO Study. Nutrients. 2016;8(9). pii: E574. - PMC - PubMed
    1. Pedersen ML, Olesen J, Jorgensen ME, Damm P. Gestational diabetes mellitus in Greenland: a national study of prevalence and testing efficacy. Int J Circumpolar Health. 2016;75: 32167. - PMC - PubMed

MeSH terms