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Indian Journal of Obstetrics and Gynecology Research


A Comparison of Insulin and Glibenclamide in the Treatment of Gestational Diabetes Mellitus


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Author Details: Pavithra.I, Sheila.K.Pillai, Jaya Vijayaraghavan

Volume : 2

Issue : 4

Online ISSN : 2394-2754

Print ISSN : 2394-2746

Article First Page : 270

Article End Page : 275


Abstract

Background and objectives: Gestational Diabetes Mellitus is an important medical disorder in pregnancy which is amenable to treatment thereby improving the maternal and neonatal morbidities to a great extent. Insulin has been the gold standard for management of GDM but has many demerits as far as patient acceptance and compliance are concerned. Oral hypoglycemic agents if proven safe can revolutionise the treatment of GDM. The present study aims to compare the efficacy of insulin and glibenclamide in the treatment of GDM and also to analyse the maternal and neonatal outcomes.
Methods: It is a prospective observational study carried out in our institution. 100 antenatal patients diagnosed as GDM by standard criteria were recruited and randomized to two study arms of 50 each. Group A was started on insulin and Group B was started on glibenclamide upto a maximum dose of 20 mg per day. Capillary blood glucose levels were monitored and patients were followed up till delivery and neonatal outcomes also were analysed.
Results: One week after starting treatment 72% of Group A and 68% of Group B achieved target levels of blood glucose and the difference was not statistically different. Before delivery 88% in Group A and 86% in Group B had values within normal range. The reduction in fasting blood glucose levels in glibenclamide group before delivery was statistically significant. The incidence of maternal and neonatal morbidities was comparable in both the groups.8% of patients had treatment failure with glibenclamide and were switched over to insulin.
Conclusion: Glibenclamide appears to be an effective treatment agent in GDM with maternal and neonatal outcomes comparable with insulin. Studies involving more number of patients are still needed before glibenclamide can be considered as an effective alternative to insulin.

Keywords: Gestational diabetes mellitus, Insulin, Glibenclamide, Target blood glucose levels, Maternal and neonatal morbidities