[Oral blood glucose-lowering medication as a monotherapy in gestational diabetes: a hotly debated topic].
Treatment of gestational diabetes mellitus is a hotly debated topic. In a recent randomized trial, metformin as a monotherapy achieved maternal and neonatal outcomes comparable to insulin treatment. In 2000, a randomized trial reported a similar favourable result with glibenclamide. The logical conclusion would be that either drug could already have a place in the usual treatment strategy in gestational diabetes. However, a number of major methodological, design and interpretation issues and shortcomings have led to the conclusion that such a point of view is not currently tenable. Therefore, neither metformin nor glibenclamide can yet have an established place as monotherapies in gestational diabetes; they can be used only in exceptionally cases.
de Valk
Harold W
HW
Universitair Medisch Centrum Utrecht, afd. Interne Geneeskunde, Utrecht, The Netherlands. h.w.devalk@umcutrecht.nl
D000284:Administration, Oral; D016640:Diabetes, Gestational / Q000188:drug therapy*; D005260:Female; D005905:Glyburide / Q000008:administration & dosage / Q000627:therapeutic use; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D007328:Insulin / Q000627:therapeutic use; D008687:Metformin / Q000008:administration & dosage / Q000627:therapeutic use; D011247:Pregnancy; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome
D007004:Hypoglycemic Agents; D007328:Insulin; D008687:Metformin; D005905:Glyburide