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Cochrane on Insulin vs Oral Meds for GDM

Cochrane; 2017 Nov 5; Brown, Grzeskowiak, et al

Insulin and oral antidiabetes medications have a similar impact on gestational diabetes mellitus (GDM) outcomes, according to a Cochrane review of 99 studies involving nearly 14,000 individuals. The findings are based on very low to moderate quality evidence. For mothers with GDM:

  • Insulin was linked with an increased likelihood of hypertensive disorders of pregnancy.
  • There was no difference in pre-eclampsia, cesarean section, developing type 2 diabetes, or postnatal weight.
  •  Insulin might increase the likelihood of induction of labor, though the results are uncertain.

For babies, there was no difference in the risk of being born large-for-gestational age, death or serious illness after birth, low blood sugar, being overweight as a baby or as a child, having a hearing or visual impairment, or mild developmental delay at 18 months. The reviewers could not find enough evidence to offer recommendations on regular human vs other insulin types, insulin vs dietary advice, insulin vs exercise, nor for different insulin doses.

Citation:

Brown J, Grzeskowiak L, Williamson K, Downie M, Crowther CA. Insulin for the treatment of women with gestational diabetes. Cochrane Database of Syst Rev. 2017, Issue 11. Art. No.: CD012037. doi:10.1002/14651858.CD012037.pub2.

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Cochrane on Diet/Exercise Role in Preventing GDM, Cochrane, 2017 Nov 12; Shepherd, Gomersal, et al

Cochrane on Insulin vs Oral Meds for GDM, Cochrane; 2017 Nov 5; Brown, Grzeskowiak, et al

Cochrane on Glucose Monitoring to Manage GDM, Cochrane, 2017 Oct 29; Raman, Shepherd, et al

New ADA Scientific Statement on CGM Systems, Diabetes Care; ePub 2017 Oct 25; Petrie, et al

Predicting Diabetes Based on HbA1c Levels, Diabetes Care; ePub 2017 Oct 26; Leong, et al