Journal of Diabetes Research / 2019 / Article / Tab 2 / Review Article
Comparative Efficacy and Safety of Metformin, Glyburide, and Insulin in Treating Gestational Diabetes Mellitus: A Meta-Analysis Table 2 Demographics of included studies.
First author Year Location Groups No. of subjects enrolled Age, mean (SD) (y) BMI at entry into the study, mean (SD) (kg/m2 ) Gestational age at entry into the study (weeks) Initiated dose Maximum dose Refuerzo 2015 America Metformin 8 30.9 (5.5) 35.9 (5.2) Unstated 500 mg/d 2500 mg/d Insulin 13 32.3 (4.3) 40.1 (8.4) Unstated 1-13 wks: 0.7 U/kg/d Unstated Anjalakshi 2007 India Glyburide 10 24.9 (3.73) 22.82 (3.50) 22.5 (4.72) 0.625 mg/wk Unstated Insulin 13 27.46 (5.83) 25.32 (5.14) 22.62 (5.62) 0.1 U/kg/d Unstated Huhtala 2018 Finland Metformin 110 31.9 (5.01) 29.5 (5.91) Unstated 500 mg/d 2000 mg/d Insulin 107 32.0 (5.47) 28.9 (4.71) Unstated Unstated Unstated Behrashi 2016 Iran Glyburide 120 30.69 (7.194) 21.94 (2.800) 24.89 (3.90) 1.25 mg/d 20 mg/d Insulin 129 29.98 (7.033) 22.59 (3.094) 24.48 (4.51) 0.2 IU/kg/d Unstated Mirzamoradi 2015 Iran Glyburide 37 29.50 (4.06) 30.18 (5.35) Unstated 1.25 mg/d 20 mg/d Insulin 59 31.18 (5.01) 31.77 (5.11) Unstated 0.4 U/kg/d Unstated Langer 2000 America Glyburide 201 29 (7) Unstated 24 (7) 2.5 mg/d 20 mg/d Insulin 203 30 (6) Unstated 25 (7) 0.7 U/kg/d Unstated Khan 2017 Pakistan Metformin 385 24.92 (2.57) 22.08 (2.98) 27.94 (2.57) 500 mg/d Unstated Insulin 385 28.01 (2.53) 23.82 (2.81) 29.92 (2.27) 0.7 U/kg/d Unstated George 2015 India Glyburide 80 33.6 (4.6) 28.8 (4.0) 29.7 (3.7) 2.5 mg/d 15 mg/d Metformin 79 33.4 (4.4) 28.7 (4.4) 29.3 (3.3) 500 mg/d 2000 mg/d Mesdaghinia 2013 Iran Insulin 100 30.2 (5.9) Unstated 28.9 (3.8) 0.5 IU/kg/d Unstated Metformin 100 29.6 (5.3) Unstated 27.9 (3.22) 500 mg/d 2000 mg/d Hague 2003 Australia Insulin 14 34.1 (3.70) 37.9 (6.87) 30.4 (4.67) Unstated Unstated Metformin 16 33.7 (4.44) 39.5 (6.94) 29.8 (4.49) Unstated Unstated Sénat 2018 France Glyburide 367 32.5 (5.1) 30.7 (5.1) Unstated 2.5 mg/d 20 mg/d Insulin 442 32.6 (5.3) 31.1 (5.4) Unstated 4 IU/d Unstated Waheed 2013 Pakistan Insulin 34 29.82 (4.58) Unstated Unstated Unstated Unstated Metformin 34 29.35 (4.97) Unstated Unstated 500 mg/d 1500 mg/d Reynolds 2017 UK Glyburide 13 33.0 (5.1) Unstated 29.6 (6.3) 2.5 mg/d 20 mg/d Insulin 10 34.59 (4.9) Unstated 31.5 (2.2) Unstated Unstated Tempe 2013 India Glyburide 32 27.5 (3.04) Unstated 25.9 (5.1) 2.5 mg/d 20 mg/d Insulin 32 26.9 (3.06) Unstated 27.3 (4.1) 4 IU/d Unstated Nachum 2017 Israel Glyburide 53 32.8 (5.0) 28.6 (4.7) Unstated 2.5 mg/d 20 mg/d Metformin 51 33.6 (5.3) 28.6 (5.5) Unstated 850 mg/d 2550 mg/d Langer 2001 America Glyburide 201 Unstated Unstated Unstated 2.5 mg/d 20 mg/d Insulin 203 Unstated Unstated Unstated 0.7 U/kg/d Unstated Ashoush 2016 Egypt Metformin 47 32.1 (3.2) 31.1 (1.3) 28.2 (1.3) 1000 mg/d 2500 mg/d Insulin 48 31.6 (2.8) 31.4 (1.5) 27.8 (1.4) 0.7 U/kg/d Unstated Eid 2018 Egypt Metformin 113 31.6 (3.6) 29.44 (4.53) 27.4 (3.9) 500 mg/d 2500 mg/d Insulin 116 30.4 (3.5) 30.5 (4.2) 28.1 (3.1) 0.7 U/kg/d Unstated Barrett 2013 Australia Metformin 236 Unstated Unstated Unstated Unstated Unstated Insulin 242 Unstated Unstated Unstated Unstated Unstated Moore 2007 America Insulin 31 27.7 (6.7) 35.3 (6.7) 28.9 (5.0) 0.7 U/kg/d Unstated Metformin 32 27.1 (4.7) 39.7 (9.0) 27.8 (6.5) 1000 mg/d 2000 mg/d Silva 2010 Brazil Glyburide 40 31.5 (5.4) 28.8 (5.8) 25.6 (6.4) 2.5 mg/d 20 mg/d Metformin 32 33.6 (5.8) 30.3 (5.7) 26.8 (6.0) 1000 mg/d 2500 mg/d Moore 2010 America Glyburide 74 29.6 (7.8) 32.7 (7.0) 29.1 (5.0) 5 mg/d 20 mg/d Metformin 75 31 (7.1) 32.8 (5.8) 27.3 (6.8) 500 mg/d 2000 mg/d Niromanesh 2012 Iran Metformin 80 30.7 (5.5) 28.1 (4.0) 28.7 (3.7) 500 mg/d 2000 mg/d Insulin 80 31.8 (5.1) 27.1 (2.1) 28.6 (3.6) 0.7 U/kg/d Unstated Hickman 2013 America Metformin 14 Unstated Unstated Unstated 500 mg/d Unstated Insulin 14 Unstated Unstated Unstated 0.7 U/kg/d Unstated Hassan 2012 Pakistan Insulin 75 30.88 (3.6) 28.74 (2.69) 29.20 (1.48) Unstated Unstated Metformin 75 30.29 (3.06) 29.17 (1.94) 29.53 (1.33) 500 mg/d 3000 mg/d Ijäs 2011 Finland Metformin 47 32.3 (5.6) 31.5 (6.5) 30 (4.9) 1st week: 750 mg/d Unstated Insulin 50 31.7 (6.1) 30.8 (5.4) 30 (4.0) Unstated Unstated Ainuddin 2015 Pakistan Metformin 16 31.75 (2.82) 28.25 (1.98) 10.75 (5.98) 500 mg/d 2500 mg/d Insulin 100 33.73 (2.95) 32.96 (4.04) 9.57 (5.20) 14-27 wks: 0.7 U/kg Unstated Rowan 2008 New Zealand Metformin 363 33.5 (5.4) 35.1 (8.3) 30.2 (3.3) 500 mg/d 2500 mg/d Insulin 370 33.0 (5.1) 34.6 (7.2) 30.1 (3.2) Unstated Unstated Beyuo 2015 Ghana Metformin 43 33.51 (4.67) 33.47 (6.95) 28.13 (2.30) 500 mg/d 2500 mg/d Insulin 40 33.10 (4.56) 32.61 (6.21) 28.26 (2.46) 0.3 IU/kg/d Unstated Hamadani 2017 Pakistan Metformin 30 30.26 (3.97) 22.94 (5.86) 28.13 (2.30) 500 mg/d 2000 mg/d Insulin 30 29.63 (3.81) 23.43 (5.06) 28.26 (2.46) Unstated Unstated Ainuddin 2015 Pakistan Metformin 43 30.6 (2.9) Unstated 29.9 (1.1) 500 mg/d 2500 mg/d Insulin 75 31 (4) Unstated 29.2 (1.5) 0.9 U/kg/d Unstated Tertti 2013 Finland Metformin 111 31.9 (5.0) 29.4 (5.9) 30.3 (2.0) 500 mg/d 1000 mg/d Insulin 107 32.1 (5.4) 28.9 (4.7) 30.4 (1.8) Unstated Unstated Lain 2009 America Insulin 41 31.2 (5.9) 30.9 (5.7) 30.6 (2.2) 0.8 U/kg Unstated Glyburide 41 32.2 (5.0) 30.8 (2.5) 2.5 mg/d Unstated Mukhopadhyay 2012 India Glyburide 30 26.3 (4.6) 23.7 (2.7) 28.3 (2.2) 2.5 mg/d 20 mg/d Insulin 30 26 (4.3) 23 (2.9) 27.4 (2.7) 0.7 U/kg/d Unstated Silva 2012 Brazil Glyburide 96 31.29 (5.36) 28.61 (5.88) 25.44 (7.13) 2.5 mg/d 20 mg/d Metformin 104 32.63 (5.61) 28.69 (5.37) 26.96 (6.44) 500 mg/d 2500 mg/d Spaulonci 2013 Brazil Metformin 46 31.93 (6.02) 31.97 (4.71) 32.18 (3.70) 1700 mg/d 2550 mg/d Insulin 46 32.76 (4.66) 31.31 (5.80) 32.05 (3.50) 0.4 U/kg/d Unstated Ghomian 2018 Iran Metformin 143 28.30 (5.25) 23.73 (1.87) 24.80 (1.45) 500 mg/d 1500 mg/d Insulin 143 28.41 (6.36) 24.0 (2.10) 25.10 (1.05) 0.1 IU/kg Unstated Saleh 2016 Egypt Metformin 67 31 (3.42) 30.52 (3.17) Unstated 500 mg/d 3000 mg/d Insulin 70 29.8 (2.18) 31.58 (30.12) Unstated 1-13 wks: 0.6 U/kg/d Unstated Refuerzo 2015 America Metformin 8 30.9 (5.5) 35.9 (5.2) Unstated 500 mg/d 2500 mg/d Insulin 13 32.3 (4.3) 40.1 (8.4) Unstated 1-13 wks: 0.7 U/kg/d Unstated Anjalakshi 2007 India Glyburide 10 24.9 (3.73) 22.82 (3.50) 22.5 (4.72) 0.625 mg/wk Unstated Insulin 13 27.46 (5.83) 25.32 (5.14) 22.62 (5.62) 0.1 U/kg/d Unstated Huhtala 2018 Finland Metformin 110 31.9 (5.01) 29.5 (5.91) Unstated 500 mg/d 2000 mg/d Insulin 107 32.0 (5.47) 28.9 (4.71) Unstated Unstated Unstated Behrashi 2016 Iran Glyburide 120 30.69 (7.194) 21.94 (2.80) 24.89 (3.90) 1.25 mg/d 20 mg/d Insulin 129 29.98 (7.033) 22.59 (3.094) 24.48 (4.51) 0.2 IU/kg/d Unstated Mirzamoradi 2015 Iran Glyburide 37 29.50 (4.06) 30.18 (5.35) Unstated 1.25 mg/d 20 mg/d Insulin 59 31.18 (5.01) 31.77 (5.11) Unstated 0.4 U/kg/d Unstated Langer 2000 America Glyburide 201 29 (7) Unstated 24 (7) 2.5 mg/d 20 mg/d Insulin 203 30 (6) Unstated 25 (7) 0.7 U/kg/d Unstated Khan 2017 Pakistan Metformin 385 24.92 (2.57) 22.08 (2.98) 27.94 (2.57) 500 mg/d Unstated Insulin 385 28.01 (2.53) 23.82 (2.81) 29.92 (2.27) 0.7 U/kg/d Unstated George 2015 India Glyburide 80 33.6 (4.6) 28.8 (4.0) 29.7 (3.7) 2.5 mg/d 15 mg/d Metformin 79 33.4 (4.4) 28.7 (4.4) 29.3 (3.3) 500 mg/d 2000 mg/d Mesdaghinia 2013 Iran Insulin 100 30.2 (5.9) Unstated 28.9 (3.8) 0.5 IU/kg/d Unstated Metformin 100 29.6 (5.3) Unstated 27.9 (3.22) 500 mg/d 2000 mg/d Hague 2003 Australia Insulin 14 34.1 (3.70) 37.9 (6.87) 30.4 (4.6) Unstated Unstated Metformin 16 33.7 (4.44) 39.5 (6.94) 29.8 (4.49) Unstated Unstated Sénat 2018 France Glyburide 367 32.5 (5.1) 30.7 (5.1) Unstated 2.5 mg/d 20 mg/d Insulin 442 32.6 (5.3) 31.1 (5.4) Unstated 4 IU/d Unstated Waheed 2013 Pakistan Insulin 34 29.82 (4.58) Unstated Unstated Unstated Unstated Metformin 34 29.35 (4.97) Unstated Unstated 500 mg/d 1500 mg/d Reynolds 2017 UK Glyburide 13 33.0 (5.1) Unstated 29.6 (6.3) 2.5 mg/d 20 mg/d Insulin 10 34.5 (4.9) Unstated 31.5 (2.2) Unstated Unstated Tempe 2013 India Glyburide 32 27.5 (3.04) Unstated 25.9 (5.1) 2.5 mg/d 20 mg/d Insulin 32 26.9 (3.06) Unstated 27.3 (4.1) 4 IU/d Unstated Nachum 2017 Israel Glyburide 53 32.8 (5.0) 28.6 (4.7) Unstated 2.5 mg/d 20 mg/d Metformin 51 33.6 (5.3) 28.6 (5.5) Unstated 850 mg/d 2550 mg/d Langer 2001 America Glyburide 201 Unstated Unstated Unstated 2.5 mg/d 20 mg/d Insulin 203 Unstated Unstated Unstated 0.7 U/kg/d Unstated Ashoush 2016 Egypt Metformin 47 32.1 (3.2) 31.1 (1.3) 28.2 (1.3) 1000 mg/d 2500 mg/d Insulin 48 31.6 (2.8) 31.4 (1.5) 27.8 (1.4) 0.7 U/kg/day Unstated Eid 2018 Egypt Metformin 113 31.6 (3.6) 29.44 (4.53) 27.4 (3.9) 500 mg/d 2500 mg/d Insulin 116 30.4 (3.5) 30.5 (4.2) 28.1 (3.1) 0.7 U/kg/d Unstated Barrett 2013 Australia Metformin 236 Unstated Unstated Unstated Unstated Unstated Insulin 242 Unstated Unstated Unstated Unstated Unstated Moore 2007 America Insulin 31 27.7 (6.7) 35.3 (6.7) 28.9 (5.0) 0.7 U/kg/d Unstated Metformin 32 27.1 (4.7) 39.7 (9.0) 27.8 (6.5) 1000 mg/d 2000 mg/d Silva 2010 Brazil Glyburide 40 31.5 (5.4) 28.8 (5.8) 25.6 (6.4) 2.5 mg/d 20 mg/d Metformin 32 33.6 (5.8) 30.3 (5.7) 26.8 (6.0) 500 mg/d 2500 mg/d Moore 2010 America Glyburide 74 29.6 (7.8) 32.7 (7.0) 29.1 (5.0) 5 mg/d 20 mg/d Metformin 75 31 (7.1) 32.8 (5.8) 27.3 (6.8) 500 mg/d 2000 mg/d Niromanesh 2012 Iran Metformin 80 30.7 (5.5) 28.1 (4.0) 28.7 (3.7) 500 mg/d 2000 mg/d Insulin 80 31.8 (5.1) 27.1 (2.1) 28.6 (3.6) 0.7 U/kg/d Unstated Hickman 2013 America Metformin 14 Unstated Unstated Unstated 500 mg/d Unstated Insulin 14 Unstated Unstated Unstated 0.7 U/kg/d Unstated Hassan 2012 Pakistan Insulin 75 30.88 (3.6) 28.74 (2.69) 29.20 (1.48) Unstated Unstated Metformin 75 30.29 (3.06) 29.17 (1.94) 29.53 (1.33) 500 mg/d 3000 mg/d Ogunyemi 2007 America Glyburide 48 Unstated 32.0 (7.6) 28.1 (7.6) Unstated Unstated Insulin 49 Unstated 30.8 (6.9) 24.6 (8.0) Unstated Unstated Bertini 2005 Brazil Glyburide 24 31.2 (4.5) Unstated 5 mg/d 20 mg/d Insulin 27 28.7 (6.0) Unstated Unstated Unstated Silva 2007 Brazil Glyburide 32 31.62 (4.19) Unstated Unstated Insulin 36 29.94 (6.02) Unstated Unstated
IRB: institutional review board; UT Health: University of Texas Health Science Center; WHO: World Health Organization; ADIPS: Australasian Diabetes in Pregnancy Society; IADPSG: International Association of the Diabetes and Pregnancy Study Groups; ADA: American Diabetes Association.
