In general , when given alongside gestational weight gain advice , fasting glucose improved in most diets compared to diets that gave gestational weight gain advice only .
However , fasting glucose increased in high unsaturated or monounsaturated fatty acids diets .
In the absence of gestational weight gain advice , fasting glucose improved in DASH-style diets compared to st and ard of care .
Although most were non-significant , similar trends were observed for these same diets for the other glycemic outcomes .
/INTERPRETATION Alongside with gestational weight gain advice , most diets , with the exception of a high unsaturated or a high monounsaturated fatty acid diet , demonstrated a fasting glucose improvement compared with gestational weight gain advice only .
When gestational weight gain advice was not given , the DASH-style diet appeared optimal on fasting glucose .
However , a small number of trials were identified and most dietary comparisons were underpowered to detect differences in glycemic outcomes .
AIMS Evidence to support dietary modifications to improve glycemia during pregnancy is limited , and the benefits of diet beyond limiting gestational weight gain is unclear .
Therefore , a systematic review and network meta- analysis of r and omized trials was conducted to compare the effects of various common diets , stratified by the addition of gestational weight gain advice , on fasting glucose and insulin , hemoglobin A1c ( HbA1c ) , and homeostatic model assessment for insulin resistance ( HOMA-IR ) in pregnant women .
A comparison of glyburide and insulin in women with gestational diabetes mellitus.
BACKGROUND Women with gestational diabetes mellitus are rarely treated with a sulfonylurea drug , because of concern about teratogenicity and neonatal hypoglycemia . There is little information about the efficacy of these drugs in this group of women . METHODS We studied 404 women with singleton pregnancies and gestational diabetes that required treatment . The women were r and omly assigned between 11 and 33 weeks of gestation to receive glyburide or insulin according to an intensified treatment protocol . The primary end point was achievement of the desired level of glycemic control . Secondary end points included maternal and neonatal complications . RESULTS The mean ( + /-SD ) pretreatment blood glucose concentration as measured at home for one week was 114+/-19 mg per deciliter ( 6.4+/-1.1 mmol per liter ) in the glyburide group and 116+/-22 mg per deciliter ( 6.5+/-1.2 mmol per liter ) in the insulin group ( P=0.33 ) . The mean concentrations during treatment were 105+/-16 mg per deciliter ( 5.9+/-0.9 mmol per liter ) in the glyburide group and 105+/-18 mg per deciliter ( 5.9+/-1.0 mmol per liter ) in the insulin group ( P=0.99 ) . Eight women in the glyburide group ( 4 percent ) required insulin therapy . There were no significant differences between the glyburide and insulin groups in the percentage of infants who were large for gestational age ( 12 percent and 13 percent , respectively ) ; who had macrosomia , defined as a birth weight of 4000 g or more ( 7 percent and 4 percent ) ; who had lung complications ( 8 percent and 6 percent ) ; who had hypoglycemia ( 9 percent and 6 percent ) ; who were admitted to a neonatal intensive care unit ( 6 percent and 7 percent ) ; or who had fetal anomalies ( 2 percent and 2 percent ) . The cord-serum insulin concentrations were similar in the two groups , and glyburide was not detected in the cord serum of any infant in the glyburide group . CONCLUSIONS In women with gestational diabetes , glyburide is a clinical ly effective alternative to insulin therapy
In general , when given alongside gestational weight gain advice , fasting glucose improved in most diets compared to diets that gave gestational weight gain advice only .
However , fasting glucose increased in high unsaturated or monounsaturated fatty acids diets .
In the absence of gestational weight gain advice , fasting glucose improved in DASH-style diets compared to st and ard of care .
Although most were non-significant , similar trends were observed for these same diets for the other glycemic outcomes .
/INTERPRETATION Alongside with gestational weight gain advice , most diets , with the exception of a high unsaturated or a high monounsaturated fatty acid diet , demonstrated a fasting glucose improvement compared with gestational weight gain advice only .
When gestational weight gain advice was not given , the DASH-style diet appeared optimal on fasting glucose .
However , a small number of trials were identified and most dietary comparisons were underpowered to detect differences in glycemic outcomes .
AIMS Evidence to support dietary modifications to improve glycemia during pregnancy is limited , and the benefits of diet beyond limiting gestational weight gain is unclear .
Therefore , a systematic review and network meta- analysis of r and omized trials was conducted to compare the effects of various common diets , stratified by the addition of gestational weight gain advice , on fasting glucose and insulin , hemoglobin A1c ( HbA1c ) , and homeostatic model assessment for insulin resistance ( HOMA-IR ) in pregnant women .