Obstetrics & Gynecology

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Obstetrics & Gynecology:
doi: 10.1097/AOG.0b013e3181c52132
Original Research

Metformin Compared With Glyburide in Gestational Diabetes: A Randomized Controlled Trial

Moore, Lisa E. MD; Clokey, Diana RPH, CDE; Rappaport, Valerie J. MD; Curet, Luis B. MD

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Abstract

OBJECTIVE: To compare the efficacy of metformin with glyburide for glycemic control in gestational diabetes.

METHODS: Patients with gestational diabetes who did not achieve glycemic control on diet were randomly assigned to metformin (n=75) or glyburide (n=74) as single agents. The primary outcome was glycemic control. Secondary outcomes were drug failure rate and neonatal and obstetric complications.

RESULTS: In the patients who achieved adequate glycemic control, the mean fasting and 2-hour postprandial blood glucose levels were not statistically different between the two groups. However, 26 patients in the metformin group (34.7%) and 12 patients in the glyburide group (16.2%) did not achieve adequate glycemic control and required insulin therapy (P=.01).

CONCLUSION: In this study, the failure rate of metformin was 2.1 times higher than the failure rate of glyburide when used in the management of gestational diabetes (95% confidence interval 1.2–3.9).

CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov, www.clinicaltrials.gov, NCT00965991.

LEVEL OF EVIDENCE: I

© 2010 by The American College of Obstetricians and Gynecologists.

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