Metformin compared with glyburide in gestational diabetes: a randomized controlled trial.
OBJECTIVE
To compare the efficacy of metformin with glyburide for glycemic control in gestational diabetes.


METHODS
Patients with gestational diabetes who did not achieve glycemic control on diet were randomly assigned to metformin (n=75) or glyburide (n=74) as single agents. The primary outcome was glycemic control. Secondary outcomes were drug failure rate and neonatal and obstetric complications.


RESULTS
In the patients who achieved adequate glycemic control, the mean fasting and 2-hour postprandial blood glucose levels were not statistically different between the two groups. However, 26 patients in the metformin group (34.7%) and 12 patients in the glyburide group (16.2%) did not achieve adequate glycemic control and required insulin therapy (P=.01).


CONCLUSIONS
In this study, the failure rate of metformin was 2.1 times higher than the failure rate of glyburide when used in the management of gestational diabetes (95% confidence interval 1.2-3.9).


BACKGROUND
ClinicalTrials.gov, www.clinicaltrials.gov, NCT00965991.


METHODS
I.
Moore
Lisa E
LE
From the Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, University of New Mexico School of Medicine, Albuquerque, New Mexico.
Clokey
Diana
D
Rappaport
Valerie J
VJ
Curet
Luis B
LB
D000328:Adult; D001786:Blood Glucose / Q000032:analysis; D016640:Diabetes, Gestational; D005260:Female; D005905:Glyburide / Q000627:therapeutic use*; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D008687:Metformin / Q000627:therapeutic use*; D011247:Pregnancy; D011256:Pregnancy Outcome; D016896:Treatment Outcome; D055815:Young Adult
D001786:Blood Glucose; D007004:Hypoglycemic Agents; D008687:Metformin; D005905:Glyburide