Kirovakov Zlatko, Gyokova Elitsa, Hinkova Nadezhda, Stoilov Boris
Department of Midwifery Care, Faculty of Health Care, Medical University - Pleven, Pleven, BGR.
Department of Obstetrics and Gynecology, Faculty of Medicine, Medical University - Pleven, Pleven, BGR.
Cureus. 2024 Sep 30;16(9):e70554. doi: 10.7759/cureus.70554. eCollection 2024 Sep.
Uncertainty surrounds the efficacy and security of several medications in treating endocrinopathies, such as gestational diabetes mellitus (GDM) in individuals whose normal glucose levels cannot be maintained by diet and exercise alone. To improve pregnancy results for GDM individuals, the present review is conducted to measure the effectiveness of several antidiabetic medications for glucose management. Up until 2024, we looked through PubMed and Google Scholar. Patients with GDM were enrolled in randomized controlled studies that examined several medications. Using the Cochrane risk of bias method, we obtained the pertinent data and evaluated the bias probability. To determine the odds ratio and the surface of the cumulative ranking function of the maternal and neonatal consequences of various therapies in GDM individuals, we first performed pair-wise meta-assessments and subsequently used a systematic review. Macrosomia, higher gestational ages, infant hypoglycemia, and birth weight are the neonatal outcomes. Glycohemoglobin (HbA1c), and pregnancy-induced hypertension (PIH) are the maternal outcomes. This thorough analysis of 25 trial designs found that metformin had fewer cases of macrosomia, higher gestational ages, infant hypoglycemia, and decreased birth weight when compared to glyburide. Metformin was found to be the fastest way to control blood sugar levels in individuals with GDM, whereas glyburide was found to be the most successful medicine for the same purpose.
几种药物在治疗内分泌疾病方面的疗效和安全性存在不确定性，例如对于仅通过饮食和运动无法维持正常血糖水平的个体的妊娠期糖尿病（GDM）。为了改善GDM个体的妊娠结局，本综述旨在衡量几种抗糖尿病药物在血糖管理方面的有效性。截至2024年，我们检索了PubMed和谷歌学术。GDM患者被纳入了研究几种药物的随机对照试验。使用Cochrane偏倚风险方法，我们获取了相关数据并评估了偏倚概率。为了确定GDM个体中各种治疗方法对母婴结局的优势比和累积排序函数表面，我们首先进行了成对的荟萃分析，随后进行了系统评价。巨大儿、孕周增加、婴儿低血糖和出生体重是新生儿结局。糖化血红蛋白（HbA1c）和妊娠高血压（PIH）是母亲结局。对25个试验设计的全面分析发现，与格列本脲相比，二甲双胍导致巨大儿、孕周增加、婴儿低血糖的病例更少，出生体重降低。发现二甲双胍是控制GDM个体血糖水平的最快方法，而格列本脲是用于同一目的最有效的药物。
