Perinatal outcomes and the use of oral hypoglycemic agents.
OBJECTIVE
To compare neonatal results from patients with gestational diabetes mellitus (GDM) who were treated with insulin, glyburide and acarbose.


RESULTS
Seventy patients diagnosed with GDM who needed therapy to complement diet and physical activities were included in the study. One group was assigned to insulin therapy (n = 27), a second group was assigned to glyburide therapy (n = 24) and a third group was assigned to acarbose therapy (n = 19). Maternal characteristics were similar in the three groups. Glucose control was not achieved in five (20.8%) of the patients using glyburide and in eight (42.1%) of patients using acarbose. No statistical difference was observed in fasting and post-prandial glucose levels or in average newborn weight in the three groups. The rate of large for gestational age (LGA) fetuses was 3.7, 25 and 10.5% in the groups treated with insulin, glyburide and acarbose, respectively. Neonatal hypoglycemia was observed in eight newborns, six of which from the glyburide group.


CONCLUSIONS
We believe that glyburide and acarbose can be promising alternative therapies for the treatment of GDM. Glyburide controlled glucose levels in most patients and it was more efficient than acarbose. Glyburide showed a higher rate of macrosomia and neonatal hypoglycemia as compared to other therapies.
Bertini
Anna Maria
AM
Obstetrics Department, Federal University of São Paulo, Brazil.
Silva
Jean Carl
JC
Taborda
Wladimir
W
Becker
Felipe
F
Lemos Bebber
Fernanda Regina
FR
Zucco Viesi
Juliana Maria
JM
Aquim
Gabriela
G
Engel Ribeiro
Thaís
T
D020909:Acarbose / Q000008:administration & dosage / Q000009:adverse effects; D000284:Administration, Oral; D000328:Adult; D001724:Birth Weight; D001786:Blood Glucose / Q000378:metabolism; D016640:Diabetes, Gestational / Q000097:blood / Q000188:drug therapy*; D005260:Female; D005320:Fetal Macrosomia / Q000209:etiology; D005905:Glyburide / Q000008:administration & dosage / Q000009:adverse effects; D006801:Humans; D007003:Hypoglycemia / Q000151:congenital / Q000209:etiology; D007004:Hypoglycemic Agents / Q000008:administration & dosage* / Q000009:adverse effects; D007231:Infant, Newborn; D007328:Insulin / Q000009:adverse effects / Q000627:therapeutic use; D011247:Pregnancy; D011256:Pregnancy Outcome
D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007328:Insulin; D005905:Glyburide; D020909:Acarbose