Oral hypoglycemic agents vs insulin in management of gestational diabetes: a systematic review and metaanalysis
Oral hypoglycemic agents vs insulin in management of gestational diabetes: a systematic review and metaanalysis
复制标题
DOI：
10.1016/j.ajog.2010.06.044
复制
发表时间：
2010-11-01
影响因子：
9.8
通讯作者：
Farrell, Tom
中科院分区：
文献类型：
--
作者：
Dhulkotia, Jaya Saxena;Ola, Bolarinde;Farrell, Tom
目的：本综述的目的是为比较口服降糖药与胰岛素在实现血糖控制方面的效果的随机对照试验提供汇总估计，并研究妊娠期糖尿病的孕产妇和围产期结局。研究设计：制定了研究方案。所有meta分析均使用Stats Direct统计软件（Stats Direct Ltd, Cheshire， UK）进行。结果：共分析了6项研究，包括1388名受试者。孕妇空腹血糖控制（加权平均差[WMD]， 1.31； 95%可信区间[CI]， 0.81-3.43）和餐后血糖控制（WMD, 0.80; 95% CI, -3.26 - 4.87）无显著差异。口服降糖药（OHAs）的使用与新生儿低血糖的风险无关（优势比[OR]， 1.59; 95% CI, 0.70-3.62），出生体重增加（WMD, 56.11; 95% CI, -42.62至154.84），剖腹产发生率（OR, 0.91; 95% CI, -0.68至1.22），或大胎龄婴儿发生率（OR, 1.01; 95% CI, 0.61-1.68）。结论：我们的研究表明，与胰岛素相比，oha在血糖控制和妊娠结局方面没有差异。
OBJECTIVE: The objective of this review was to provide pooled estimates of randomized controlled trials comparing the effects of oral hypoglycemic agents with insulin in achieving glycemic control and to study the maternal and perinatal outcomes in gestational diabetes mellitus.STUDY DESIGN: A protocol for the study was developed. All metaanalyses were performed using Stats Direct statistical software (Stats Direct Ltd, Cheshire, UK).RESULTS: Six studies comprising 1388 subjects were analyzed. No significant differences were found in maternal fasting (weighted mean difference [WMD], 1.31; 95% confidence interval [CI], 0.81-3.43) or postprandial (WMD, 0.80; 95% CI, -3.26 to 4.87) glycemic control. Use of oral hypoglycemic agents (OHAs) was not associated with risk of neonatal hypoglycemia (odds ratio [OR], 1.59; 95% CI, 0.70-3.62), increased birthweight (WMD, 56.11; 95% CI, -42.62 to 154.84), incidence of caesarean section (OR, 0.91; 95% CI, -0.68 to 1.22), or incidence of large-for-gestational-age babies (OR, 1.01; 95% CI, 0.61-1.68).CONCLUSION: Our study demonstrates that there are no differences in glycemic control or pregnancy outcomes when OHAs were compared with insulin.