Aim of the work: The aim of this study is to compare metformin and glibenclamide in treatment of gestational diabetes mellitus regarding the efficacy in glycemic control and safety.
Patients and Methods: Eighty patients aged between 18 and 40 years who were diagnosed to have gestational diabetes mellitus between 16 and 34 weeks that was failed to be controlled by diet and exercise and required medical therapy were recruited. They were allocated to either metformin or glibenclamide therapy. The primary outcome was failure of glycemic control according to fasting and postprandial glucose values. Secondary outcomes were obstetric outcomes, maternal and neonatal complications.
Results: Patients in metformin group had significantly higher failure of glycemic control than patients in glibenclamide group (10 cases in metformin group versus 3 cases in glibenclamide group; p=0.003). Also, mean fasting glucose level was significantly higher in metformin group than glibenclamide group (87.38 ± 7.4 and 82.42 ± 6.4 mg/dl, respectively, p= 0.005), while both groups had comparable post-prandial glucose levels (p= 0.11).
Both groups had comparable rate of maternal and neonatal complications. There was no significant difference between both groups regarding gestational age and mode of delivery.However, more neonates developed hypoglycemia <40 mg/dl in glibenclamide group than metformin group (11 and 6, respectively, p= 0.025).
Conclusion: Metformin and glibenclamide are comparable oral drugs for treatment of gestational diabetes that requires medical treatment regarding maternal and fetal outcomes with preference of glibenclamide in terms of better glycemic control.