Effects of insulin combined with metformin on maternal and neonatal outcomes in the treatment of gestational diabetes mellitus in China:A meta-analysis
10.16753/j.cnki.1008-2344.2024.03.013
- VernacularTitle:国内胰岛素联合二甲双胍治疗妊娠期糖尿病对母婴结局影响的Meta分析
- Author:
Jianhua CHEN
1
;
Zhenqiu HUANG
;
Jing WEN
;
Chunlei YU
Author Information
1. 川北医学院药学院药理学教研室,川北医学院药物研究所,四川 南充 637000
- Keywords:
gestational diabetes mellitus;
insulin;
metfor-min;
meta-analysis
- From:
Journal of Shenyang Medical College
2024;26(3):292-298
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To systematically evaluate the effects of insulin combined with metformin in the treatment of gestational diabetes mellitus(GDM)on maternal and neonatal outcomes in China,in order to provide evidence-based medical recommendations for clinical treatment.Methods:The Chinese Academic Database(CNKI),VIP Database,and Wanfang Database were searched from the establishment of the database to April 2022 for randomized controlled trials(RCTs)of insulin combined with metformin versus insulin alone in the treatment of GDM to observe the adverse outcomes for neonates.The Cochrane Collaboration was used for quality evaluation and Review Manager 5.4 software was utilized for meta-analysis.Results:A total of 51 studies were included in the meta-analysis,including 4 916 GDM patients,with 2 460 cases in the combined treatment group and 2 456 cases in insulin alone group.The meta-analysis results revealed significant reductions in rates of cesarean section(OR=0.32,95%CI:0.26-0.39),preterm birth(OR=0.26,95%CI:0.20-0.34),polyhydramnios(OR=0.27,95%CI:0.20-0.36),gestational hypertension(OR=0.25,95%CI:0.18-0.35),neonatal jaundice(OR=0.25,95%CI:0.19-0.32),neonatal hypoglycemia(OR=0.33,95%CI:0.25-0.45),macrosomia(OR=0.23,95%CI:0.17-0.30),and neonatal respiratory distress(OR=0.23,95%CI:0.16-0.34)in the combined treatment group than those in the control group(P＜0.01).Conclusions:For patients with GDM,insulin combined with metformin is significantly more effective than insulin alone in reducing the incidence of maternal and neonatal complications.This combination therapy results in improved outcomes for both mothers and infants.
