AUTHOR=Wang Tingting , Zhang Wei 

TITLE=Application of Gestational Blood Glucose Control During Perinatal Period in Parturients with Diabetes Mellitus: Meta-Analysis of Controlled Clinical Studies

JOURNAL=Frontiers in Surgery

VOLUME=9

YEAR=2022

URL=https://www.frontiersin.org/journals/surgery/articles/10.3389/fsurg.2022.893148

DOI=10.3389/fsurg.2022.893148

ISSN=2296-875X

ABSTRACT=<sec><title>Background</title><p>Gestational diabetes mellitus (GDM) is a common metabolic disorder. Hyperglycemia may cause gestational hypertension, increase the probability of infection, abnormal embryonic development, and increase the abortion rate. Oral hypoglycemic drugs may be another effective means of blood glucose control in addition to insulin injection. We included controlled clinical studies for meta-analysis to understand the effect of oral hypoglycemic drugs in gestational diabetes.</p></sec><sec><title>Methods</title><p>The databases were searched with the keywords “<italic>Glycemic control</italic>” &amp; “<italic>gestational diabetes</italic>”: Embase (January, 2000–August, 2021), Pubmed (January, 2000–August, 2021), Web of Science (January, 2000–August, 2021), Ovid (January, 2000–August, 2021), and <italic>ClinicalTrials.org</italic> to obtain the randomized controlled trial (RCT) literatures related to the treatment of gestational diabetes with oral hypoglycemic drugs, after screening, the <italic>R</italic> language toolkit was used for the analysis.</p></sec><sec><title>Results</title><p>A total of 10 articles with a total of 1,938 patients were included, 7 studies used <italic>metformin</italic> as an hypoglycemic agent. Meta-analysis showed that oral <italic>metformin</italic> had no significant difference in fasting blood glucose levels after the intervention compared with insulin injection [<italic>MD </italic>= −0.35, 95%CI(−0.70,1.40), <italic>Z </italic>= 0.66, <italic>P </italic>= 0.51], with no significant difference in postprandial blood glucose levels after intervention [<italic>MD </italic>= −2.20, 95%CI(−5.94,1.55), <italic>Z </italic>= −1.15, <italic>P </italic>= 0.25], and no statistical difference in glycosylated hemoglobin [<italic>MD </italic>= 0.10, 95%CI(−0.17,−0.04), <italic>Z </italic>= −0.94, <italic>P </italic>= 0.31]. <italic>Metformin</italic> was more conducive to reducing maternal weight during pregnancy than insulin [<italic>MD </italic>= −1.55, 95%CI(−2.77,−0.34), <italic>Z </italic>= −2.5, <italic>P </italic>= 0.0123], <italic>metformin</italic> reduced the abortion rate compared with insulin [<italic>RR </italic>= 0.81, 95%CI(0.63,1.05), <italic>Z </italic>= −2.61, <italic>P </italic>= 0.015], and reduced cesarean section rate [<italic>RR </italic>= 0.66, 95%CI(0.49,0.90), <italic>Z </italic>= −3.95, <italic>P </italic>= 0.0001].</p></sec><sec sec-type="discussion"><title>Discussion</title><p>The application of oral hypoglycemic drug <italic>metformin</italic> in blood glucose control of gestational diabetes can play a hypoglycemic effect equivalent to insulin and can control the weight of pregnant women, reduce the rate of abortion and cesarean section, and improve pregnancy outcomes.</p></sec>