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Systematic review with meta analysis
In women with gestational diabetes requiring drug treatment, glibenclamide may be inferior to insulin and metformin: metformin (plus insulin when required) performs better than insulin
  1. Dana Carroll,
  2. Kristi W Kelley
  1. Department of Pharmacy Practice, Auburn University Harrison School of Pharmacy, Auburn, Alabama, USA
  1. Correspondence to : Professor Dana Carroll, Department of Pharmacy Practice, Auburn University Harrison School of Pharmacy, 850 5th Ave East, Auburn, AL 35401, USA; dgc0001{at}auburn.edu

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Insulin therapy is recommended as a first-line approach after failure of diet therapy to manage gestational diabetes (GDM).1 ,2 Not all women are suitable candidates or decline to use insulin to manage their blood glucose levels and alternative options are needed. Metformin and glibenclamide are mentioned as alternatives to insulin for management of gestational diabetes mellitus (GDM) in several guidelines,1 ,2 while National Institute for Health and Care Excellence guidelines recommend metformin as a first-line.3 This systematic review and meta-analysis examines the short-term maternal and neonatal outcomes in women with GDM receiving glibenclamide, metformin or insulin in randomised controlled trials (RCTs). …

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