Systematic Reviews Of Treatment Of Gestational Diabetes

Objective:To assess the effectiveness and safety of metformin and glibenclamide for the treatment of gestational diabetes.Methods:"gestational diabetes, metformin, glibenclamide, insulin, perinatal outcome "for the search terms, through the computer search literatures from MEDLINE (Pubmed,1974-2011years), Chinese biomedical journals (1978-2011years), Chinese academic Journal (1979-2012years) Google Scholar (1978-2011years), the new England Journal of Medicine (1990-2011years), full-text database of Elsevier electronic journals (1990-2011years). The literatures requirement for clinical randomized controlled test. Assess the quality and draw data from these literatures. At the same time hand searches of relevant literatures (including journal supplements and conference summary literatures). Evaluate the quality of the included studies,data analysis using RevMan5.0.Results:On the basis of inclusion criteria, bring into the seven randomized controlled trials by means of strictly screened, a total of2243subjects, of which four groups of glibenclamide and insulin-controlled trials, three groups controlled trials of metformin and insulin. Analytically, the included studies do not exist significant clinical heterogeneity. Founding that glibenclamide with insulin and metformin with insulin therapy in adverse perinatal outcomes (such as macrosomia, congenital malformations,neonatal hyper-bilirubinemia, neonatal respiratory distress syndrome, neonatal intensive care unit occupancy rate, incidence of neonatal mortality, etc.) and intrauterine growth (birth weight, length), were not statistically significant difference (P>0.05). Comparing with insulin, glibenclamide and metformin may improve the compliance of treatment, and the metformin groups have lower incidence in neonatal hypoglycemia than in the insulin groups, and there was statistical significance (P=0.0002).Conclusion:Both metformin and glibenclamide do not increase the incidence of adverse perinatal outcomes. And there were no adverse effects on fetal growth and development.Metformin can reduce the incidence of neonatal hypoglycemia.They all can be used for the treatment of gestational diabetes.