Abstract:Objective: To compare the major outcomes of use of metformin and glyburide in treatment of gestational diabetes mellitus. Methods: Studies published in English, in the last 10 years, in the databases MEDLINE ® , SciELO, LILACS and Cochrane Library were analyzed, and randomized controlled trials were selected. Health Sciences Descriptors were used to compose the search phrase, and the keywords "Gestational diabetes", "Glyburide", "Metformin" and their variations were searched in the Medical Subject Headings. PR… Show more
“…Like metformin, glyburide can cross the placenta and potentially affect a growing fetus [43]. Multiple meta-analyses sought to compare the safety and efficacy of glyburide with metformin therapy in pregnancy, as these are the only oral diabetic agents currently available for this population and are commonly prescribed in combination with insulin [100][101][102][103]. Glyburide is about equal to metformin in its contribution to glycemic control in pregnant women with diabetes.…”
Section: Pharmacotherapy In Pregnancymentioning
confidence: 99%
“…A meta-analysis that compared glyburide and metformin in patients with GDM found no difference in fasting blood glucose (p = 0.821), postprandial blood glucose (p = 0.217) and birth weight (p = 0.194) between the interventions. However, glyburide is associated with more adverse effects, including maternal weight gain, macrosomia, neonatal hypoglycemia, and neonatal disease [100]. When safety and efficacy are evaluated, glyburide seems to be inferior to metformin in the treatment of diabetes in pregnancy because it has more adverse effects and only comparable efficacy, with a lack of long-term data on its effects on the fetus.…”
The treatment of type 2 diabetes (T2D) necessitates a multifaceted approach that combines behavioral and pharmacological interventions to mitigate complications and sustain a high quality of life. Treatment encompasses the management of glucose levels, weight, cardiovascular risk factors, comorbidities, and associated complications through medication and lifestyle adjustments. Metformin, a standard in diabetes management, continues to serve as the primary, first-line oral treatment across all age groups due to its efficacy, versatility in combination therapy, and cost-effectiveness. Glucagon-like peptide-1 receptor agonists (GLP-1 RA) offer notable benefits for HbA1c and weight reduction, with significant cardiovascular benefits. Sodium-glucose cotransporter inhibitors (SGLT-2i) lower glucose levels independently of insulin while conferring notable benefits for cardiovascular, renal, and heart-failure outcomes. Combined therapies emphasizing early and sustained glycemic control are promising options for diabetes management. As insulin therapy remains pivotal, metformin and non-insulin agents such as GLP-1 RA and SGLT-2i offer compelling options. Notably, exciting novel treatments like the dual GLP-1/ glucose-dependent insulinotropic polypeptide (GIP) agonist show promise for substantially reducing glycated hemoglobin and body weight. This comprehensive review highlights the evolving landscape of pharmacotherapy in diabetes, the drugs currently available for treating diabetes, their effectiveness and efficacy, the impact on target organs, and side effects. This work also provides insights that can support the customization of treatment strategies.
“…Like metformin, glyburide can cross the placenta and potentially affect a growing fetus [43]. Multiple meta-analyses sought to compare the safety and efficacy of glyburide with metformin therapy in pregnancy, as these are the only oral diabetic agents currently available for this population and are commonly prescribed in combination with insulin [100][101][102][103]. Glyburide is about equal to metformin in its contribution to glycemic control in pregnant women with diabetes.…”
Section: Pharmacotherapy In Pregnancymentioning
confidence: 99%
“…A meta-analysis that compared glyburide and metformin in patients with GDM found no difference in fasting blood glucose (p = 0.821), postprandial blood glucose (p = 0.217) and birth weight (p = 0.194) between the interventions. However, glyburide is associated with more adverse effects, including maternal weight gain, macrosomia, neonatal hypoglycemia, and neonatal disease [100]. When safety and efficacy are evaluated, glyburide seems to be inferior to metformin in the treatment of diabetes in pregnancy because it has more adverse effects and only comparable efficacy, with a lack of long-term data on its effects on the fetus.…”
The treatment of type 2 diabetes (T2D) necessitates a multifaceted approach that combines behavioral and pharmacological interventions to mitigate complications and sustain a high quality of life. Treatment encompasses the management of glucose levels, weight, cardiovascular risk factors, comorbidities, and associated complications through medication and lifestyle adjustments. Metformin, a standard in diabetes management, continues to serve as the primary, first-line oral treatment across all age groups due to its efficacy, versatility in combination therapy, and cost-effectiveness. Glucagon-like peptide-1 receptor agonists (GLP-1 RA) offer notable benefits for HbA1c and weight reduction, with significant cardiovascular benefits. Sodium-glucose cotransporter inhibitors (SGLT-2i) lower glucose levels independently of insulin while conferring notable benefits for cardiovascular, renal, and heart-failure outcomes. Combined therapies emphasizing early and sustained glycemic control are promising options for diabetes management. As insulin therapy remains pivotal, metformin and non-insulin agents such as GLP-1 RA and SGLT-2i offer compelling options. Notably, exciting novel treatments like the dual GLP-1/ glucose-dependent insulinotropic polypeptide (GIP) agonist show promise for substantially reducing glycated hemoglobin and body weight. This comprehensive review highlights the evolving landscape of pharmacotherapy in diabetes, the drugs currently available for treating diabetes, their effectiveness and efficacy, the impact on target organs, and side effects. This work also provides insights that can support the customization of treatment strategies.
“…Current studies have demonstrated that the occurrence and development of GDM is influenced by multiple factors, among which genetic, metabolic and environmental factors are important in the pathogenesis of GDM (5). Currently, we recommend dietary modification and increasing appropriate physical activity to improve gestational diabetes, and when basic methods cannot control blood glucose, insulin therapy (6) or oral hypoglycemic agents, mainly metformin and glibenclamide (7), are mostly used. The majority of current studies have focused on hypoglycemic approaches to treat GDM.…”
BackgroundStudies have demonstrated that high iron status is positively associated with gestational diabetes mellitus (GDM), implying that iron overload and ferroptosis play important roles in the development of GDM. The aim of this study was to explore effective therapeutic drugs from traditional Chinese medicine (TCM)formulas for the treatment of GDM based on ferroptosis.MethodsIn this study, the presence of ferroptosis in the placenta was verified through clinical and experimental data, and key genes were subsequently screened for association with ferroptosis in the development of GDM. The analysis was based on transcriptome sequencing of datasets combined with differentially expressed genes (DEGs) analysis and weighted gene correlation network analysis (WGCNA); functional enrichment analysis was also performed. A protein−protein interaction (PPI) network was constructed and pivotal genes were identified using Cytoscape. Finally, traditional Chinese medicine (TCM)formulas related to treating GDM were collected, then the proteins corresponding to the key genes were molecularly docked with the small molecular structures of clinically proven effective herbal tonics, and molecular dynamic simulations were performed to select the best candidates for pharmacological compounds.ResultsElevated ferritin levels in patients with GDM were verified using clinical data. The presence of ferroptosis in placental tissues of patients with GDM was confirmed using electron microscopy and western blotting. Ninety-nine key genes with the highest correlation with ferroptosis were identified from DEGs and weighted gene co-expression network analysis (WGCNA). Analysis using the Kyoto Encyclopedia of Genes and Genomes demonstrated that the DEGs were primarily involved in the oxidative phosphorylation pathway. The key genes were further screened by PPI; two key genes, SF3B14 and BABAM1, were identified by combining the gene corresponding to protein structure and function, followed by molecular docking and molecular dynamic simulation. Coptis chinensis was proposed as the best candidate for herbal treatment at the molecular level.ConclusionThis data revealed the presence of ferroptosis in patients with GDM and identified possible modulatory roles of ferroptosis-related genes involved in the molecular mechanisms of GDM, providing new insights into the pathogenesis of GDM, which also provided new directions for the systematic optimization of TCM formulas for the management and targeted treatment of GDM.
“…The basic methods of treating GDM include an appropriate diet and increased physical activity, and when these are inadequate, pharmacotherapy, usually insulin therapy, is used. In developing countries, such as Brazil, oral hypoglycemic agents are also used, mainly metformin and glibenclamide (glyburide) [ 10 ]. The prevention and appropriate treatment of GDM are needed to reduce the morbidity, complications and economic effects of GDM that affect society, households and individuals.…”
Gestational diabetes mellitus (GDM), which is defined as a state of hyperglycemia that is first recognized during pregnancy, is currently the most common medical complication in pregnancy. GDM affects approximately 15% of pregnancies worldwide, accounting for approximately 18 million births annually. Mothers with GDM are at risk of developing gestational hypertension, pre-eclampsia and termination of pregnancy via Caesarean section. In addition, GDM increases the risk of complications, including cardiovascular disease, obesity and impaired carbohydrate metabolism, leading to the development of type 2 diabetes (T2DM) in both the mother and infant. The increase in the incidence of GDM also leads to a significant economic burden and deserves greater attention and awareness. A deeper understanding of the risk factors and pathogenesis becomes a necessity, with particular emphasis on the influence of SARS-CoV-2 and diagnostics, as well as an effective treatment, which may reduce perinatal and metabolic complications. The primary treatments for GDM are diet and increased exercise. Insulin, glibenclamide and metformin can be used to intensify the treatment. This paper provides an overview of the latest reports on the epidemiology, pathogenesis, diagnosis and treatment of GDM based on the literature.
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