Gestational Diabetes Mellitus Clinical Trial
Official title:
Gestational Diabetes Mellitus: Insulin or Oral Hypoglycemic Agents?
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.
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