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
In women with gestational diabetes, the failure rate of metformin to control glucose levels adequately is 2.1 times greater than that of glyburide.
From the Department of Obstetrics and Gynecology, Division of Maternal–Fetal Medicine, University of New Mexico School of Medicine, Albuquerque, New Mexico.
Corresponding author: Lisa E. Moore, MD, Department of Ob-Gyn, Division of Maternal–Fetal Medicine, University of New Mexico School of Medicine, MSC 10 5580, 1 University of New Mexico, Albuquerque NM 87131-0001; e-mail: firstname.lastname@example.org.
Financial Disclosure: The authors did not report any potential conflicts of interest.