Systematic Review
Year: 2022 | Month: July-September | Volume: 7 | Issue: 3 | Pages: 336-344
DOI: https://doi.org/10.52403/ijshr.20220746
Metformin Versus Glyburide in the Management of Gestational Diabetes; A Systematic Review and Meta-Analysis
David Chinaecherem Innocent1; Advait Vasavada2; Angelica Chinecherem Uwaezuoke3; Princess Chidiebube Uwaezuoke4; Rejoicing Chijindum Innocent5
1Department of Public Health, Federal University of Technology Owerri, Imo State Nigeria
2MP Shah Medical College, Jamnagar, India
3Department of Medicine and Surgery, University of Nigeria, Nsukka, Enugu State, Nigeria
4Department of Pharmacy, University of Nigeria Teaching Hospital, Ituku-Ozalla Enugu State, Nigeria
5Department of Pharmacy, Enugu State University of Science and Technology, Enugu State, Nigeria
Corresponding Author: David Chinaecherem Innocent
ABSTRACT
Background: Globally gestational diabetes remains one most common medical problem facing a significant proportion of women in pregnancy. Understanding safe therapeutic and management measures is imperative to inform effective and sound decision and judgment for clinicians and concerned groups.
Aim: This review aimed to compare the effectiveness and safety of Metformin versus Glyburide in managing gestational diabetes mellitus (GDM).
Methods: Cochrane Library, PUBMED, MEDLINE and LILACs were subjected to literature search for randomized controlled trials addressing the primary aim of this study. The Key used for the search strategy was: “Metformin”, “Glyburide”, ‘Gestational Diabetes” and other varying terms from Medical subject Headings. The review systematized a PRISMA Checklist and demonstrated Meta analyzed studies mathematically on weight gain after using glyburide and metformin during and after pregnancy, fasting blood glucose, birthweight and postprandial blood glucose.
Results: Neonatal hypoglycaemia, mode of delivery, birth weight, Apgar score, weight during and after pregnancy, postprandial blood glucose and requirement for intensive care were all assessed in the study. In 60% of the studies safety and efficacy of glyburide and metformin diabetes management showed no significant difference. From postprandial blood glucose (P=0.217), birth weight (p=0.194), and fasting blood glucose (p=0.821) revealed no statistical differences between the medications in the meta analysis conducted. However, on the other hand, weight growth during pregnancy among patients revealed significant variations (p=0.036).
Conclusion: Both metformin and glyburide showed no differences in safety and efficacy considering birth weight, fasting blood glucose and postprandial blood glucose. However, in babies of women treated with metformin, problems associated with neonates such as respiratory issues and hypoglycemia and also increase in weight during pregnancy or gestation are more less common and lower.
Keywords: Diabetes, Therapy, Metformin, Glyburide, Gestational Diabetes Mellitus