The effect of dipeptidyl peptidase-4 inhibitor and glucagon-like peptide-1 receptor agonist in gestational diabetes mellitus: a systematic review

Abstract

Gestational diabetes mellitus (GDM) is the most common complication in pregnancy and affects 13% pregnant women around the world. GDM has both short-term and long-term negative effect on mother and offspring. Dipeptidyl peptidase-4 (DPP-4) inhibitor and glucagon-like peptide-1 receptor agonist (GLP-1 Ra) have shown many extra-benefits in diabetes patients, and may be a promising choice to GDM. Here, we conducted a systematic review of randomized controlled trials to investigate the effect of DPP-4 inhibitor and GLP-1 Ra in GDM. This project was conducted based on the Preferred Reporting Items for Systematic Reviews and Meta Analyses (PRISMA) statement. We searched PubMed, EMBASE and Cochrane library up to November 8 2019 for eligible trials. A total of 982 records were identified and 4 trials (516 participants) met the criteria in the end. The results suggested that DPP-4 inhibitor and GLP-1 Ra can reduce the rate of developing postpartum diabetes, help to normalization of blood glucose and improve insulin resistance and β-cell function. Although the treatments showed beneficial effects in GDM patients, but the present data could not prove it use in GDM. Further clinical trials will be needed.

摘要：

妊娠期糖尿病（GDM）是妊娠期最常见的并发症, 影响着全球13%的孕妇。GDM对母子双方都有近期和远期的负面影响。在糖尿病患者中, 二肽基肽酶-4（DPP-4）抑制剂和胰高血糖素样肽-1受体激动剂（GLP-1 Ra）有很多额外的益处, 可能是对GDM患者一个有前景的治疗方法。本研究是随机对照研究, 对DPP-4抑制剂和GLP-1 Ra在GDM患者中的作用进行了系统研究。该项目基于系统评价和荟萃分析优先报告的条目（PRISMA）。截至2019年11月8日, 我们搜索了PubMed、EMBASE和Cochrane图书馆, 以获得合格的实验。最终共发现982份记录, 4项试验（516名参与者）符合标准。结果提示, DPP-4抑制剂和GLP-1 Ra可降低产后糖尿病的发生率, 有助于血糖正常化, 改善胰岛素抵抗和β细胞功能。虽然这些治疗方法在GDM患者中显示出有益的效果, 但是目前的数据不能证明它可以在GDM患者中应用。还需要进一步的临床试验。

The Chinese abstracts are translated by Prof. Dr. Xiangyan Ruan and her team: Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, China.

Keywords:

• DPP-4 inhibitor
• GLP-1 receptor agonist
• GDM
• insulin resistance
• blood glucose

Disclosure statement

All authors have no conflict of interest.

Additional information

Funding

This project is funded by Sanming Project of Medicine in Shenzhen, SZSM201812056.