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https://www.readbyqxmd.com/read/29142561/feto-maternal-outcomes-and-glycemic-control-in-metformin-versus-insulin-treated-gestational-diabetics
#1
Rabia Arshad, Samia Khanam, Fuad Shaikh, Nasim Karim
Objective: To evaluate and compare feto-maternal outcomes and glycemic control in metformin versus insulin treated gestational diabetics. Methods: The study was conducted in 2010- 2012 as a part of M. Phil at Civil hospital, Lyari General Hospital and Mamji Hospital in Karachi. After written informed consent, 71 GDM diagnosed females with WHO criteria were enrolled. They were divided into two groups. Group-A, 32 females were given oral metformin 500 mg TDS while Group-B, 39 females were given insulin 0...
September 2017: Pakistan Journal of Medical Sciences Quarterly
https://www.readbyqxmd.com/read/29125636/very-tight-versus-tight-control-which-should-be-the-criteria-for-pharmacologic-therapy-dose-adjustment-in-diabetes-in-pregnancy-evidence-from-randomized-controlled-trials
#2
Claudia Caissutti, Gabriele Saccone, Andrea Ciardulli, Vincenzo Berghella
INTRODUCTION: There is inconclusive evidence from randomized controlled trials (RCTs) to support any specific criteria for pharmacologic therapy dose adjustment in diabetes in pregnancy. Our objective was to analyze the criteria for dose adjustment of pharmacologic treatment for diabetes mellitus (DM) in pregnancy. MATERIAL AND METHODS: Data sources: MEDLINE, OVID and Cochrane Library were searched from their inception to September 2017. Selection criteria included all trials of DM in pregnancy managed by oral hypoglycemic agents or insulin reporting criteria for pharmacologic therapy dose adjustment...
November 10, 2017: Acta Obstetricia et Gynecologica Scandinavica
https://www.readbyqxmd.com/read/29106783/gestational-diabetes-is-diet-and-insulin-the-only-solution
#3
(no author information available yet)
Gestational diabetes (GDM) is a relatively common complication of pregnancy. Maternal hyperglycemia causes many serious side effects for mothers, fetuses and newborns. In 90% of women diagnosed with GDM, a dietary treatment results in satisfactory levels of blood glucose. The remaining 10% require insulin therapy to achieve the recommended glycemic levels. The majority of recent studies show the efficiency of metformin in gestational diabetes and prove that it is not a cause for any harmful side effects to the embryo and/or fetus...
October 6, 2017: Neuro Endocrinology Letters
https://www.readbyqxmd.com/read/29103210/insulin-for-the-treatment-of-women-with-gestational-diabetes
#4
REVIEW
Julie Brown, Luke Grzeskowiak, Kathryn Williamson, Michelle R Downie, Caroline A Crowther
BACKGROUND: Gestational diabetes mellitus (GDM) is associated with short- and long-term complications for the mother and her infant. Women who are unable to maintain their blood glucose concentration within pre-specified treatment targets with diet and lifestyle interventions will require anti-diabetic pharmacological therapies. This review explores the safety and effectiveness of insulin compared with oral anti-diabetic pharmacological therapies, non-pharmacological interventions and insulin regimens...
November 5, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29094444/metformin-as-a-prophylactic-treatment-of-gestational-diabetes-in-pregnant-patients-with-pregestational-insulin-resistance-a-randomized-study
#5
Enrique Valdés, Alvaro Sepúlveda-Martínez, Paula Candia, Nancy Abusada, Rodrigo Orellana, Bárbara Manukian, Eduardo Cuellar
AIM: We aimed to assess the use of metformin (MTF) in the prevention of gestational diabetes mellitus (GDM) in patients with pregestational insulin resistance (PIR). METHODS: A double blind, multicenter, randomized trial was carried out in patients with a history of PIR and pregestational MTF treatment. Groups were allocated either to MTF 1700 mg/day or placebo. Patients were recruited between 12(+0) and 15(+6)  gestational weeks, and treatment was extended until week 36...
November 2, 2017: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/29082364/effect-of-metformin-on-maternal-and-neonatal-outcomes-in-pregnant-obese-non-diabetic-women-a-meta-analysis
#6
Ahmed Elmaraezy, Abdelrahman Ibrahim Abushouk, Amany Emara, Omar Elshahat, Hussien Ahmed, Magdy I Mostafa
BACKGROUND: Metformin reduces maternal and neonatal weight gain in gestational diabetes mellitus; however, this effect is poorly investigated in non-diabetic women. OBJECTIVE: We performed this meta-analysis to investigate the effect of metformin intake during pregnancy on maternal and neonatal outcomes in obese non-diabetic women. MATERIALS AND METHODS: We searched Medline, EMBASE, and Cochrane CENTRAL for eligible randomized controlled trials addressing the efficacy of metformin in pregnant obese non-diabetic women...
August 2017: International Journal of Reproductive Biomedicine (Yazd, Iran)
https://www.readbyqxmd.com/read/29070511/metformin-in-gestational-diabetes-mellitus-predictors-of-poor-response
#7
Inês Gante, Luís Melo, Jorge Dores, Luísa Ruas, Maria do Céu Almeida
OBJECTIVE: Metformin can be regarded as a first-line treatment in Gestational Diabetes Mellitus (GDM) due to its safety and effectiveness. However, a proportion of women do not achieve adequate glycemic control with metformin alone. We aim to identify predictors of this poor response to metformin. DESIGN AND METHODS: Retrospective multicentre cohort study of women with GDM who started metformin as first-line treatment. The assessed cohort was divided into a metformin group and metformin plus insulin group...
October 25, 2017: European Journal of Endocrinology
https://www.readbyqxmd.com/read/29045765/oral-anti-diabetic-agents-for-women-with-established-diabetes-impaired-glucose-tolerance-or-previous-gestational-diabetes-planning-pregnancy-or-pregnant-women-with-pre-existing-diabetes
#8
REVIEW
Joanna Tieu, Suzette Coat, William Hague, Philippa Middleton, Emily Shepherd
BACKGROUND: While most guidance recommends the use of insulin in women whose pregnancies are affected by pre-existing diabetes, oral anti-diabetic agents may be more acceptable to women. The effects of these oral anti-diabetic agents on maternal and infant health outcomes need to be established in pregnant women with pre-existing diabetes or impaired glucose tolerance, as well as in women with previous gestational diabetes mellitus preconceptionally or during a subsequent pregnancy. This review is an update of a review that was first published in 2010...
October 18, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28948952/efficacy-of-metformin-in-improving-glycaemic-control-perinatal-outcome-in-gestational-diabetes-mellitus-a-non-randomized-study
#9
Neeta Singh, Malti Madhu, Perumal Vanamail, Nisha Malik, Sunesh Kumar
BACKGROUND & OBJECTIVES: Gestational diabetes mellitus (GDM) can cause adverse perinatal outcome if not treated. Although insulin therapy has been the main treatment modality over decades but considering its cost and parenteral mode of administration, it does not seem to be appropriate, especially in low-resource settings. The objective of this study was to evaluate the role of metformin in GDM and know its efficacy as well as adverse effect on foetus and mother. METHODS: All pregnant women with GDM who were not controlled on medical nutrition therapy and required metformin therapy were included in the study...
May 2017: Indian Journal of Medical Research
https://www.readbyqxmd.com/read/28948948/metformin-in-gestational-diabetes-mellitus
#10
Reva Tripathi, Shakun Tyagi, Vandana Goel
No abstract text is available yet for this article.
May 2017: Indian Journal of Medical Research
https://www.readbyqxmd.com/read/28938877/glibenclamide-and-metformin-versus-standard-care-in-gestational-diabetes-graces-a-feasibility-open-label-randomised-trial
#11
Rebecca M Reynolds, Fiona C Denison, Ed Juszczak, Jennifer L Bell, Jessica Penneycard, Mark W J Strachan, Robert S Lindsay, Claire I Alexander, Corinne D B Love, Sonia Whyte, Fiona Mackenzie, Ben Stenson, Jane E Norman
BACKGROUND: Metformin is widely used to treat gestational diabetes (GDM), but many women remain hyperglycaemic and require additional therapy. We aimed to determine recruitment rate and participant throughput in a randomised trial of glibenclamide compared with standard therapy insulin (added to maximum tolerated metformin) for treatment of GDM. METHODS: We conducted an open label feasibility study in 5 UK antenatal clinics among pregnant women 16 to 36 weeks' gestation with metformin-treated GDM...
September 22, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28930827/comparative-efficacy-and-safety-of-oral-antidiabetic-drugs-and-insulin-in-treating-gestational-diabetes-mellitus-an-updated-prisma-compliant-network-meta-analysis
#12
Hui-Ling Liang, Shu-Juan Ma, Yan-Ni Xiao, Hong-Zhuan Tan
BACKGROUND: The safety and efficacy of different drugs in treatment of gestational diabetes mellitus (GDM) patients who could not maintain normal glucose level only through diet and exercise remains to be debated. We performed this network meta-analysis (NAM) to compare and rank different antidiabetic drugs in glucose level control and pregnancy outcomes in GDM patients. METHODS: We searched PubMed, Cochrane Library, Web of Science, and Embase up to December 31, 2016...
September 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28921513/use-of-a-clinical-laboratory-score-to-guide-treatment-of-gestational-diabetes
#13
Juliana B do Valle, Jean C Silva, Daniela S Oliveira, Lisiane Martins, Amanda Lewandowski, Wagner Horst
OBJECTIVE: To assess the outcomes of implementing a clinical-laboratory score in the treatment of pregnant women with gestational diabetes. METHODS: A retrospective before-and-after implementation analysis was undertaken using data and neonatal outcomes for pregnant women with gestational diabetes treated before (January 2011-December 2012; control group) and after (January 2013-December 2014; score group) introduction of a newly developed score. To evaluate the effects of score adoption, odds ratios with 95% confidence intervals were calculated after adjustment for confounding factors...
September 16, 2017: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/28867217/in-utero-and-lactational-exposure-to-metformin-induces-reproductive-alterations-in-male-rat-offspring
#14
Simone Forcato, Daniella Regina Barrionuevo da Silva Novi, Nathalia Orlandini Costa, Lorena Ireno Borges, Maria Luiza Marino de Góes, Graziela Scalianti Ceravolo, Daniela Cristina Ceccatto Gerardin
Metformin (MET) is prescribed for the treatment of type 2 diabetes mellitus and gestational diabetes. Although MET crosses the placenta, it is considered safe throughout gestation. However, it has been shown in humans that maternal exposure to MET increases sex hormone binding globulin levels in newborns, and in rats it decreases the testosterone concentration at gestational day (GD) 16.5. Therefore, the present study evaluated if maternal exposure to MET could interfere with reproductive parameters of male offspring...
September 1, 2017: Reproductive Toxicology
https://www.readbyqxmd.com/read/28864965/pharmacological-management-of-gestational-diabetes-mellitus
#15
Geetha Mukerji, Denice S Feig
Gestational diabetes mellitus (GDM) is associated with an increased risk of adverse pregnancy outcomes in the setting of poor glycemic control. The initial management for GDM includes intensive lifestyle modification, which often requires behavioral and nutritional changes to optimize glycemic control. Pharmacotherapy for GDM is initiated when glycemic targets are not met. The rapid-acting bolus analogues aspart and lispro achieve postprandial targets with less hypoglycemia compared to regular insulin, with similar fetal outcomes...
October 2017: Drugs
https://www.readbyqxmd.com/read/28810587/association-of-polycystic-ovary-syndrome-with-metabolic-syndrome-and-gestational-diabetes-aggravated-complication-of-pregnancy
#16
Kui Yao, Ce Bian, Xia Zhao
Polycystic ovary syndrome (PCOS) affects 5-20% of the reproductive age women globally. PCOS is diagnosed by the presence of hyperandrogenism, oligo-anovulation, and polycystic morphology of at least one ovary. Insulin resistance (IR), hyperinsulinemia and associated metabolic abnormalities including metabolic syndrome play a significant role in the development of PCOS. The chances of developing MS in PCOS women was shown to increase by almost 14-fold in patients with increasing body mass index. Even in the absence of overt obesity, a preferential deposition of intra-abdominal fat is noted in PCOS women and this intra-abdominal fat leads to impaired insulin action and functional IR and hyperandrogenism...
August 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28770322/metformin-for-diabetes-prevention-insights-gained-from-the-diabetes-prevention-program-diabetes-prevention-program-outcomes-study
#17
REVIEW
Vanita R Aroda, William C Knowler, Jill P Crandall, Leigh Perreault, Sharon L Edelstein, Susan L Jeffries, Mark E Molitch, Xavier Pi-Sunyer, Christine Darwin, Brandy M Heckman-Stoddard, Marinella Temprosa, Steven E Kahn, David M Nathan
The largest and longest clinical trial of metformin for the prevention of diabetes is the Diabetes Prevention Program/Diabetes Prevention Program Outcomes Study (DPP/DPPOS). In this review, we summarise data from the DPP/DPPOS, focusing on metformin for diabetes prevention, as well as its long-term glycaemic and cardiometabolic effects and safety in people at high-risk of developing diabetes. The DPP (1996-2001) was a RCT of 3234 adults who, at baseline, were at high-risk of developing diabetes. Participants were assigned to masked placebo (n = 1082) or metformin (n = 1073) 850 mg twice daily, or intensive lifestyle intervention (n = 1079)...
August 2, 2017: Diabetologia
https://www.readbyqxmd.com/read/28731890/metformin-exposure-during-pregnancy-and-lactation-did-not-cause-vascular-reactivity-alteration-in-adult-male-offspring
#18
Daniella R B S Novi, Simone Forcato, Camila B Vidigal, Guilherme H Loiola, Daniela C C Gerardin, Graziela S Ceravolo
Metformin has been used for the treatment of some metabolic diseases during gestation and the beneficial effects of metformin to the vascular system have been described in diabetic and obese animal models. Nevertheless, the long term consequences to the vascular system of offspring maternally exposed to metformin have not yet been characterized. Therefore, we want to test the hypothesis that gestational and lactational exposure to metformin would be safe for the vascular reactivity of male adult offspring. Wistar female rats were treated with metformin 293mg/kg/day, by gavage, from gestational day (GD) 0 to GD 21 (METG) or GD 0 until post natal day (PND) 21 (METGL)...
July 19, 2017: Journal of Cardiovascular Pharmacology
https://www.readbyqxmd.com/read/28691362/basal-bolus-insulin-therapy-reduces-maternal-triglycerides-in-gestational-diabetes-without-modifying-cholesteryl-ester-transfer-protein-activity
#19
Pablo R Olmos, Gisella R Borzone
AIM: Macrosomia in the offspring of overweight/obese mothers with glucose-controlled gestational diabetes mellitus (GDM) is due to excessive rise of maternal triglycerides (TG). We aimed to ascertain whether basal-bolus insulin therapy (BBIT), or other components of the treatment, could reduce TG in GDM. METHODS: We studied the records of 131 singleton pregnancies with GDM, using stepwise multiple linear regression, Mann-Whitney, χ(2) , and Jonckheere-Terpstra tests...
July 10, 2017: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/28647726/treatments-for-gestational-diabetes-a-systematic-review-and-meta-analysis
#20
Diane Farrar, Mark Simmonds, Maria Bryant, Trevor A Sheldon, Derek Tuffnell, Su Golder, Debbie A Lawlor
OBJECTIVE: To investigate the effectiveness of different treatments for gestational diabetes mellitus (GDM). DESIGN: Systematic review, meta-analysis and network meta-analysis. METHODS: Data sources were searched up to July 2016 and included MEDLINE and Embase. Randomised trials comparing treatments for GDM (packages of care (dietary and lifestyle interventions with pharmacological treatments as required), insulin, metformin, glibenclamide (glyburide)) were selected by two authors and double checked for accuracy...
June 24, 2017: BMJ Open
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