COMPARATIVE STUDY BETWEEN EFFECTIVENESS OF GLIBENCLAMIDE VERSUS INSULIN IN MANAGEMENT OF GESTATIONAL DIABETES

Abstract

Background: Gestational diabetes mellitus (GDM) offers an important opportunity for diagnosis and implementation of clinical strategies for diabetes prevention. Objective: To evaluate the effectiveness of glibenclamide versus insulin in the management of GDM in second half of pregnancy. Patients and methods: This experimental prospective comparative study was carried out. A total of 100 women aged below 35 years were included in the study from those attending the Outpatient Clinic of Obstetrics and Gynecology Department of Al-Ahrar Teaching Hospital in Zagazig, Egypt, through the period from July 2017 to March 2020, and they were randomly allocated and divided into two groups 50 patients in each. The first group (A) received glibenclamide at an oral dose of 2.5-5 mg once or twice a day with a maximum dose of 10 mg/day and the second group (B) received standard insulin mixtard therapy. Dosing was based upon subcutaneous two shot combined dose of intermediate acting and short-acting insulin given prior to breakfast and dinner. The starting dose was 0.7 units per kilogram of the body weight at admission and increased weekly as necessary. Results: The delivery type was comparable in both groups, 28% of women underwent vaginal delivery in glibenclamide group, and 22% of women underwent vaginal delivery in insulin group. 72% and 78% of women underwent cesarean section in glibenclamide and insulin groups respectively. The gestational age at delivery was comparable in both groups. Conclusion: Glibenclamide seem to be a simple, safe, inexpensive and attractive alternative to insulin for the treatment of gestational diabetes mellitus.