title: Perinatal impact of the use of metformin and glyburide for the treatment of gestational diabetes mellitus.
abstract: OBJECTIVE
  To evaluate the perinatal impact of metformin and glyburide in the treatment of gestational diabetes mellitus (GDM).
  
  
  METHODS
  A randomized clinical trial conducted from July 2008 until September 2010 studied 200 pregnant women with GDM who required adjunctive therapy to diet and physical activity. Patients were randomized to use metformin (n=104) or glyburide (n=96). The drugs were replaced by insulin when they reached the maximum dose without glycemic control. Assessed outcomes: weight and neonatal blood glucose.
  
  
  RESULTS
  No difference was found (P>0.05) between the groups regarding maternal age, gestational age at inclusion, body mass index, glucose levels in oral glucose tolerance test (OGTT) 75 g and glycemic control. Difference was found in the number of previous pregnancies (2.84 vs. 2.47, P=0.04) and weight gain during pregnancy (7.78 vs. 9.84, P=0.04) in the metformin group and glyburide respectively. The perinatal results showed no difference (P>0.05) in the percentage of cesarean deliveries, gestational age at delivery, number of newborns large for gestational age (LGA), neonatal hypoglycemia, admission to intensive care unit and perinatal death. We found differences in weight (3193 g vs. 3387 g, P=0.01) and ponderal index (2.87 vs. 2.96, P=0.05) of newborns, and in neonatal blood glucose levels at the 1st (59.78 vs. 54.08, P=0.01) and 3rd h (61.53 vs. 55.89, P=0.01) after birth between the metformin and glyburide groups respectively.
  
  
  CONCLUSIONS
  Weight and ponderal index were lower in the newborns of the metformin group; glucose levels (1st and 3rd h after birth) were lower in the glyburide group.
authors.affiliation: Department of Obstetrics, Universidade da Região de Joinville (UNIVILLE), Joinville, Brazil.
authors.forename: Jean Carl
authors.initials: JC
authors.lastname: Silva
authors.forename: Débora Raquel Rigon Narciso
authors.initials: DR
authors.lastname: Fachin
authors.forename: Morgana Leonora
authors.initials: ML
authors.lastname: Coral
authors.forename: Anna Maria
authors.initials: AM
authors.lastname: Bertini
mesh_terms: D000328:Adult; D001724:Birth Weight / Q000187:drug effects; D001786:Blood Glucose / Q000378:metabolism; D016640:Diabetes, Gestational / Q000188:drug therapy* / Q000473:pathology; D005260:Female; D005951:Glucose Tolerance Test; D005905:Glyburide / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D007231:Infant, Newborn; D008297:Male; D008687:Metformin / Q000009:adverse effects / Q000627:therapeutic use*; D011247:Pregnancy; D011256:Pregnancy Outcome; D015430:Weight Gain / Q000187:drug effects
chemical_list: D001786:Blood Glucose; D007004:Hypoglycemic Agents; D008687:Metformin; D005905:Glyburide