Insulin detemir versus glyburide in women with gestational diabetes mellitus

Abstract

Aim: To evaluate the safety, efficacy and pregnancy outcomes of insulin detemir (IDet) versus glyburide treatment in women with gestational diabetes mellitus (GDM).

Methods: We conducted a retrospective cohort study of women with GDM who were treated with either glyburide or IDet for GDM in a university-affiliated tertiary hospital.

Results: Ninety-one patients with GDM were enrolled, 62 were administered glyburide and 29 IDet. Maternal age, pregestational body mass index (BMI) and rate of abnormal oral glucose tolerance test (OGTT) blood glucose values were not significantly different between groups. Good glycemic control rates were comparable. Hypoglycemic episodes were reported only in the glyburide group (19.4% versus 0%, p = 0.01). Maternal weight gain during pregnancy was significantly higher among women in the glyburide group (8.8 ± 5.1 kg, p < 0.001) compared to those in the IDet group (2.1 ± 19.9 kg, p = 0.71).

Conclusions: To the best of our knowledge, this is the first study on IDet treatment in patients with GDM. By our preliminary results, IDet is a viable treatment option in women with GDM. Further large prospective studies are needed to determine the efficacy and safety of IDet in GDM patients.

Chinese abstract

目的: 评估地特胰岛素 (IDet) 与格列苯脲治疗妊娠期糖尿病 (GDM) 患者的安全性、有效性和妊娠结局。

方法: 我们进行了回顾性队列研究, 调查患GDM的女性曾在某大学三级附属医院应用格列苯脲或IDet治疗。

结果: 91名GDM患者参与了本研究, 62名采用格列苯脲治疗, 29名采用IDet治疗。母亲年龄、孕前体质量指数 (BMI) 和口服葡萄糖耐量试验 (OGTT) 血糖值异常率在两组无显著差异。良好的血糖控制率具有可比性。低血糖发作仅出现在格列苯脲组 (19.4% vs 0%, p = 0.01) 。孕期母亲体重增加在格列苯脲组 (8.8 ± 5.1 kg, p＜0.001) 较IDet组 (2.1 ± 19.9 kg, p = 0.71) 显著增加。

结论: 据我们所知, 这是首个关于地特胰岛素治疗GDM患者的研究。我们先前的研究表明, IDet是GDM女性可选择的治疗方法。下一步需要大型的前瞻性研究来确定IDet治疗GDM患者的有效性和安全性。

Keywords:

• Gestational diabetes
• glyburide
• hypoglycemia
• insulin detemir

Declaration of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.