STUDY OF THE COMPARISON OF EFFICACY OF GLIBENCLAMIDE AND INSULIN IN THE GESTATIONAL DIABETES MELLITUS TREATMENT

Gestational diabetes mellitus is an important medical condition that is predisposing to treatment that greatly improves maternal and neonatal morbidities. The gold standard for the GDM management is Insulin, but it has many disadvantages in terms of patient acceptance and appropriateness. Oral hypoglycemic agents can revolutionize the treatment of GDM if they are proven safe. Objective: The aim of this study was to compare the glibenclamide and insulin efficacy in the management of GDM and to analyze neonatal and maternal outcomes. Study Design: A prospective observational study. Place and Duration: In the Obstetrics and Gynecology department of Holy Family Hospital, Rawalpindi for one year duration from October 2017 to October 2018. Methods: We recruited 100 antenatal GDM diagnosed patients according to given criteria and were randomly assigned to 50 study groups. The insulin was given in Group A and glibenclamide in group B up to a maximum of 20 mg daily. In patients BSR were recorded and were monitored until birth and outcomes of neonates were also analyzed. Results: After 7 days of treatment, in A 72% group and in 68% of group B the target blood glucose level was achieved and this variation was not different statistically. Prior to delivery, BSR in Group A improved in 88% and in Group B 86%. The decrease in fasting blood glucose levels was statistically significant in glibenclamide group before delivery. The neonatal and maternal morbidity incidence in both groups was comparable. 8% of patients failed with glibenclamide treatment and started using insulin. Conclusion: In GDM, glibenclamide supposed to be an effective treatment agent with neonatal and maternal outcomes as compared to insulin. Further analysis is required before considered glibenclamide is granted as effective alternative to insulin.