Managing Glycemic Control in Pregnancy: Comparing Antidiuretic Medications and Insulin Regimens"

Abstract

Background: The disease known as gestational diabetes mellitus, or GDM, was first identified as a result of reduced glucose tolerance during pregnancy. Glycemic management must be maintained to prevent negative effects for both the mother and the foetus. We evaluate the efficacy of insulin and anti-diabetic regimens in the treatment of GDM in this research. Objectives: to assess the effectiveness of insulin regimens and anti-diabetic medications in controlling blood sugar levels during pregnancy in relation to the family objectives of the patient, such as a healthy baby, and to provide medical professionals with information on the best ways to treat gestational diabetes mellitus. Study design: A cross sectional study. Place and duration of study. Department of endocrinology hmc peshwar from 10-Feb 2022 to july Feb-2022 Methods:The study used a cross-sectional methodology. To locate relevant randomised controlled trials comparing different insulin regimens and antidiabetic drugs in pregnant women with gestational diabetes mellitus (GDM), a thorough search was carried out across major electronic databases. Included were studies that reported on glycemic control outcomes, such as HbA1c levels, fasting blood glucose levels, and the incidence of unfavourable outcomes for either the mother or the foetus. Both the quality evaluation and data extraction were carried out separately by two reviewers. To analyse the effectiveness of various therapies while taking both direct and indirect evidence into account, a network meta-analysis was carried out. Sensitivity analysis were carried out to evaluate how solid the results were. Based on variables such maternal health condition and gestational age, subgroup analyses were carried out. The objective of the synthesised data was to enhance the outcomes for women with gestational diabetes mellitus (GDM) by offering insights into the relative effectiveness of insulin regimens and antidiabetic drugs in glycemic management during pregnancy. Results:There were 100 participants in the research, with an average age of 28. The biggest impact on HbA1c levels was from insulin treatment (mean decrease = -1.5%), which was followed by oral hypoglycemic medications (mean reduction = -1.2%) and modifying one's lifestyle (mean reduction = -0.8%). The trends in fasting blood glucose levels were comparable. The results for mothers and foetuses, including birth weight and Apgar ratings, did not vary statistically across the treatment groups, suggesting that glycemic management is essential irrespective of the therapeutic approach. Conclusion: Our study emphasises the value of individualised methods to treating GDM, with a focus on the effectiveness of oral hypoglycemic medications, insulin therapy, and lifestyle changes in achieving glycemic control. Further investigation into the long-term impacts on maternal and foetal outcomes is necessary to enhance clinical practice. Keywords: gestational diabetes, glycemic control, antidiabetic medications, insulin therapy