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Gestational Diabetes: Insulin or Oral Hypoglycemic Agents?

Phase 3
Completed
Conditions
Gestational Diabetes Mellitus
Interventions
Drug: Metformin, glyburide and insulin
Registration Number
NCT01215331
Lead Sponsor
Université de Sherbrooke
Brief Summary

Gestational diabetes mellitus takes place in 2 steps. First, it is the consequence of insulin resistance due to the modifications of the pregnancy hormonal environment, and second, of the deficiency of the beta cells of the pancreas to respond by a sufficient insulin secretion. This physiopathology is closely connected to the one of type 2 diabetes. Insulin, indeed, can remedy these 2 etiologies, but it is logical to think about using oral hypoglycemic agents which have been created to treat them: they are a natural choice because they improve insulin sensitivity (metformin, a biguanide) or insulin secretion (glyburide, a sulfonylurea). It also seems natural to use them in combination, glyburide being added to metformin if needed.

OUR GENERAL RESEARCH HYPOTHESIS IS THAT: in pregnant women with gestational diabetes mellitus, using both oral hypoglycemic agents (glyburide added to metformin if needed) allows a glycemic control comparable to the one obtained with insulin, but with a better acceptability from women and a better health status, diabetes treatment satisfaction and well-being and a reduced postnatal depression.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
Female
Target Recruitment
73
Inclusion Criteria
  • women,
  • age ≥ 18 yrs,
  • with gestational diabetes at 24-28 weeks (Canadian Diabetes Association (CDA) criteria),
  • who need a pharmacological treatment following the failure of the diet and exercise,
  • to understand and read French or English.
Exclusion Criteria
  • known type 1 or type 2 diabetes,
  • treatment interfering with glucose metabolism,
  • allergies to one of the components of the treatment,
  • hepatic or hematologic diseases.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Oral Hypoglycemic AgentsMetformin, glyburide and insulinMetformin + glyburide + insulin if needed
InsulinInsulinRapid acting insulin and long acting insulin
Primary Outcome Measures
NameTimeMethod
Glycemic control36 and 37th week of gestation

Mean of the capillary glycemic control at 36 and 37th week of gestation.

Secondary Outcome Measures
NameTimeMethod
Acceptability of the treatment8-12 weeks after delivery

Trial Locations

Locations (1)

Centre de recherche clinique du CHUS

🇨🇦

Sherbrooke, Quebec, Canada

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