Cochrane · systematic review · CD011967
Oral anti‐diabetic pharmacological therapies for the treatment of women with gestational diabetes
Brown, J, Martis, R, Hughes, B, et al. · Cochrane Database of Systematic Reviews · 2017 · Cochrane Library
Pregnancy and ChildbirthAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
42
current version
GRADE rated
18
No studies
24
Included studies
NR
No studies 24 · 57.1%Ungraded 0 · 0%Very low 7 · 16.7%Low 10 · 23.8%Moderate 1 · 2.4%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Oral anti‐diabetic pharmacological therapies versus placebo ‐ maternal outcomes
Population: women diagnosed with gestational diabetes; 24‐30 weeks' gestation; singleton pregnancy.
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Hypertensive disorders of pregnancy ‐ (any type) Oral anti‐diabetic pharmacological therapies vs placebo ‐ maternal outcomes | RR 1.24 [0.81, 1.9] | 1 study · 375 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Caearean section Oral anti‐diabetic pharmacological therapies vs placebo ‐ maternal outcomes | RR 1.03 [0.79, 1.34] | 1 study · 375 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Development of type 2 diabetes ‐ not measured Oral anti‐diabetic pharmacological therapies vs placebo ‐ maternal outcomes | no estimate extracted | NR | No studies |
Perineal trauma Oral anti‐diabetic pharmacological therapies vs placebo ‐ maternal outcomes | RR 0.98 [0.06, 15.62] | 1 study · 375 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Return to pre‐pregnancy weight ‐ not measured Oral anti‐diabetic pharmacological therapies vs placebo ‐ maternal outcomes | no estimate extracted | NR | No studies |
Postnatal depression ‐ not measured Oral anti‐diabetic pharmacological therapies vs placebo ‐ maternal outcomes | no estimate extracted | NR | No studies |
Induction of labour Oral anti‐diabetic pharmacological therapies vs placebo ‐ maternal outcomes | RR 1.18 [0.79, 1.76] | 1 study · 375 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Oral anti‐diabetic pharmacological therapies versus placebo ‐ neonatal outcomes
Population: infants of women diagnosed with gestational diabetes
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Large‐for‐gestational age Oral anti‐diabetic pharmacological therapies vs placebo ‐ neonatal outcomes | RR 0.89 [0.51, 1.58] | 1 study · 375 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Perinatal mortality Oral anti‐diabetic pharmacological therapies vs placebo ‐ neonatal outcomes | no estimate extracted | NR | No studies |
Death or serious morbidity composite ‐ not reported Oral anti‐diabetic pharmacological therapies vs placebo ‐ neonatal outcomes | no estimate extracted | NR | No studies |
Neonatal hypoglycaemia Oral anti‐diabetic pharmacological therapies vs placebo ‐ neonatal outcomes | RR 1.97 [0.36, 10.62] | 1 study · 375 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Adiposity (neonate, child, adult) ‐ not measured Oral anti‐diabetic pharmacological therapies vs placebo ‐ neonatal outcomes | no estimate extracted | NR | No studies |
Diabetes (child, adult) ‐ not measured Oral anti‐diabetic pharmacological therapies vs placebo ‐ neonatal outcomes | no estimate extracted | NR | No studies |
Neurosensory disability in later childhood ‐ not measured Oral anti‐diabetic pharmacological therapies vs placebo ‐ neonatal outcomes | no estimate extracted | NR | No studies |
Metformin versus glibenclamide ‐ maternal outcomes
Population: women diagnosed with gestational diabetes
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Hypertensive disorders of pregnancy Metformin vs glibenclamide ‐ maternal outcomes | RR 0.7 [0.38, 1.3] | 3 studies · 508 participants | Moderate Downgraded: risk of bias |
Caesarean section Metformin vs glibenclamide ‐ maternal outcomes | RR 1.2 [0.83, 1.72] | 4 studies · 554 participants | Low Downgraded: risk of bias, inconsistency |
Development of type 2 diabetes ‐ not measured Metformin vs glibenclamide ‐ maternal outcomes | no estimate extracted | NR | No studies |
Perineal trauma Metformin vs glibenclamide ‐ maternal outcomes | RR 1.67 [0.22, 12.52] | 2 studies · 308 participants | Low Downgraded: risk of bias, imprecision |
Return to pre‐pregnancy weight ‐ not measured Metformin vs glibenclamide ‐ maternal outcomes | no estimate extracted | NR | No studies |
Postnatal depression ‐ not measured Metformin vs glibenclamide ‐ maternal outcomes | no estimate extracted | NR | No studies |
Induction of labour Metformin vs glibenclamide ‐ maternal outcomes | RR 0.81 [0.61, 1.07] | 1 study · 159 participants | Low Downgraded: risk of bias, imprecision |
Metformin versus glibenclamide ‐ neonatal outcomes
Population: Infants of women diagnosed with gestational diabetes
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Large‐for‐gestational age Metformin vs glibenclamide ‐ neonatal outcomes | RR 0.67 [0.24, 1.83] | 2 studies · 246 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Perinatal mortality Metformin vs glibenclamide ‐ neonatal outcomes | RR 0.92 [0.06, 14.55] | 2 studies · 359 participants | Very low Downgraded: risk of bias |
Death or serious morbidity composite Metformin vs glibenclamide ‐ neonatal outcomes | RR 0.54 [0.31, 0.94] | 1 study · 159 participants | Low Downgraded: imprecision |
Neonatal hypoglycaemia Metformin vs glibenclamide ‐ neonatal outcomes | RR 0.86 [0.42, 1.77] | 4 studies · 554 participants | Low Downgraded: risk of bias, imprecision |
Adiposity ‐ not measured Metformin vs glibenclamide ‐ neonatal outcomes | no estimate extracted | NR | No studies |
Diabetes ‐ not measured Metformin vs glibenclamide ‐ neonatal outcomes | no estimate extracted | NR | No studies |
Neurosensory disability in later childhood ‐ not measured Metformin vs glibenclamide ‐ neonatal outcomes | no estimate extracted | NR | No studies |
Glibenclamide versus acarbose ‐ maternal outcomes
Population: women diagnosed with gestational diabetes; 11 to 33 weeks' gestation; singleton pregnancy
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Hypertensive disorders of pregnancy ‐ not reported Glibenclamide vs acarbose ‐ maternal outcomes | no estimate extracted | NR | No studies |
Caesarean section Glibenclamide vs acarbose ‐ maternal outcomes | RR 0.95 [0.53, 1.7] | 1 study · 43 participants | Low |
Development of type 2 diabetes ‐ not reported Glibenclamide vs acarbose ‐ maternal outcomes | no estimate extracted | NR | No studies |
Perineal trauma ‐ not reported Glibenclamide vs acarbose ‐ maternal outcomes | no estimate extracted | NR | No studies |
Return to pre‐pregnancy weight ‐ not reported Glibenclamide vs acarbose ‐ maternal outcomes | no estimate extracted | NR | No studies |
Postnatal depression ‐ not reported Glibenclamide vs acarbose ‐ maternal outcomes | no estimate extracted | NR | No studies |
Induction of labour ‐ not reported Glibenclamide vs acarbose ‐ maternal outcomes | no estimate extracted | NR | No studies |
Glibenclamide versus acarbose ‐ neonatal outcomes
Population: women with gestational diabetes
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Large‐for‐gestational age Glibenclamide vs acarbose ‐ neonatal outcomes | RR 2.38 [0.54, 10.46] | 1 study · 43 participants | Low Downgraded: risk of bias, imprecision |
Perinatal mortality Glibenclamide vs acarbose ‐ neonatal outcomes | no estimate extracted | 1 study · 43 participants | Low Downgraded: risk of bias, imprecision |
Death or serious morbidity composite ‐ not reported Glibenclamide vs acarbose ‐ neonatal outcomes | no estimate extracted | NR | No studies |
Neonatal hypoglycaemia Glibenclamide vs acarbose ‐ neonatal outcomes | RR 6.33 [0.87, 46.32] | 1 study · 43 participants | Low Downgraded: risk of bias, imprecision |
Adiposity ‐ not reported Glibenclamide vs acarbose ‐ neonatal outcomes | no estimate extracted | NR | No studies |
Diabetes ‐ not reported Glibenclamide vs acarbose ‐ neonatal outcomes | no estimate extracted | NR | No studies |
Neurosensory disability in later childhood ‐ not reported Glibenclamide vs acarbose ‐ neonatal outcomes | no estimate extracted | NR | No studies |