Managing Glycemic Control in Pregnancy: Comparing Antidiuretic Medications and Insulin Regimens"

Original Article

Abstract

Background: Gestational diabetes mellitus, or GDM, was first identified as a result of reduced glucose tolerance during pregnancy. Glycemic management must be maintained to prevent adverse effects on both the mother and the foetus. In this research, we evaluate the efficacy of insulin and antidiabetic regimens in treating GDM.

Objectives: This study assesses the effectiveness of insulin regimens and antidiabetic medications in controlling blood sugar levels during pregnancy in relation to the patient's family objectives, such as a healthy baby, and provides medical professionals with information on the best ways to treat gestational diabetes mellitus.

Study design: A cross-sectional study.

Place and duration of study. Department of Endocrinology HMC Peshawar from 10-Feb 2022 to July Feb-2022

Methods: The study used a cross-sectional methodology. To locate relevant randomized controlled trials comparing different insulin regimens and antidiabetic drugs in pregnant women with gestational diabetes mellitus (GDM), a thorough search was carried out across major electronic databases. Included were studies that reported glycemic control outcomes, such as HbA1c levels, fasting blood glucose levels, and the incidence of unfavourable outcomes for either the mother or the foetus. The quality evaluation and data extraction were carried out separately by two reviewers. A network meta-analysis was carried out to analyze the effectiveness of various therapies while considering both direct and indirect evidence. Sensitivity analyses were carried out to evaluate how solid the results were. Subgroup analyses were carried out based on variables such as maternal health condition and gestational age. The objective of the synthesized data was to enhance the outcomes for women with gestational diabetes mellitus (GDM) by offering insights into the relative effectiveness of insulin regimens and antidiabetic drugs in glycemic management during pregnancy.

Results: There were 100 participants in the research, with an average age of 28. The most significant impact on HbA1c levels was from insulin treatment (mean decrease = -1.5%), which was followed by oral hypoglycemic medications (mean reduction = -1.2%) and modifying one's lifestyle (mean reduction = -0.8%). The trends in fasting blood glucose levels were comparable. The results for mothers and foetuses, including birth weight and Apgar ratings, did not vary statistically across the treatment groups, suggesting that glycemic management is essential irrespective of the therapeutic approach.

Conclusion: Our study emphasizes the value of individualized methods for treating GDM, with a focus on the effectiveness of oral hypoglycemic medications, insulin therapy, and lifestyle changes in achieving glycemic control. Further investigation into the long-term impacts on maternal and foetal outcomes is necessary to enhance clinical practice.

Keywords: gestational diabetes, glycemic control, antidiabetic medications, insulin therapy