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Efficacy and safety of hypoglycemic agents on gestational diabetes mellitus in women: A Bayesian network analysis of randomized controlled trials.
Wang, Ting; Jing, Yingyu; Guo, Haonan; Xu, Jing; Wang, Man; Huang, Lili; Chen, Huan; Cui, Wei; Song, Lin; Liu, Xiang; Sun, Bo; Wang, Ning.
Afiliación
  • Wang T; Department of Endocrinology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
  • Jing Y; Department of Respiratory Medicine, Xi'an People's Hospital (Xi'an No. 4 Hospital), Xi'an, China.
  • Guo H; Department of Endocrinology and Second Department of Geriatrics, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
  • Xu J; Department of Endocrinology and Second Department of Geriatrics, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
  • Wang M; Department of Endocrinology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
  • Huang L; Department of Cardiovascular Medicine, Xi'an People's Hospital (Xi'an No. 4 Hospital), Xi'an, China.
  • Chen H; Department of Medical Ultrasound, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
  • Cui W; Department of Endocrinology and Second Department of Geriatrics, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
  • Song L; Department of Endocrinology and Second Department of Geriatrics, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
  • Liu X; Department of Physiology and Pathophysiology, School of Basic Medical Sciences, Xi'an Jiaotong University Health Science Center, Xi'an, China.
  • Sun B; Chinese Journal of Woman and Child Health Research, Xi'an, China.
  • Wang N; Department of Physiology and Pathophysiology, School of Basic Medical Sciences, Xi'an Jiaotong University Health Science Center, Xi'an, China.
Front Public Health ; 10: 980578, 2022.
Article en En | MEDLINE | ID: mdl-36530712
Objective: To compare the efficacy and safety of metformin, glyburide, and insulin for GDM, we conducted a subgroup analysis of outcomes for women with GDM according to the International Association of Diabetes and Pregnancy Study Groups (IADPSG) diagnostic criteria. Methods: We searched the NCBI, Embase, and Web of Science databases from inception to March 2022. Randomized controlled trials (RCTs) that compared the outcomes of hypoglycemic agents in women with GDM were included. Bayesian network analysis was employed. Results: A total of 29 RCTs were included. Metformin was estimated to lead to a slight improvement in total gestational weight gain (WMD - 1.24 kg, 95% CI -2.38, -0.09), a risk of unmet treatment target in the sensitivity analysis (OR 34.50, 95% CI 1.18-791.37) than insulin. The estimated effect of metformin showed improvements in birth weight than insulin (WMD - 102.58 g, 95% CI -180.45 to -25.49) and glyburide (WMD - 137.84 g, 95% CI -255.31 to -25.45), for hypoglycemia within 1 h of birth than insulin (OR 0.65, 95% CI 0.47 to 0.84). The improvement in the estimated effect of metformin for hypoglycemia within 1 h of birth still existed when compared with glyburide (OR 0.41, 95% CI 0.26 to 0.66), whether in the IADPSG group (OR 0.33, 95% CI 0.12 to 0.92) or not (OR 0.43, 95% CI 0.20 to 0.98). Conclusion: Metformin is beneficial for GDM women to control total GWG compared with insulin, regulate fetal birth weight more than insulin and glyburide, and increase the risk of unmet treatment targets compared with insulin. Compared to metformin, glyburide is associated with neonatal hypoglycemia.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Diabetes Gestacional / Hipoglucemia / Metformina Tipo de estudio: Clinical_trials Límite: Female / Humans / Newborn / Pregnancy Idioma: En Revista: Front Public Health Año: 2022 Tipo del documento: Article País de afiliación: China Pais de publicación: Suiza
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Diabetes Gestacional / Hipoglucemia / Metformina Tipo de estudio: Clinical_trials Límite: Female / Humans / Newborn / Pregnancy Idioma: En Revista: Front Public Health Año: 2022 Tipo del documento: Article País de afiliación: China Pais de publicación: Suiza