الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Diabetes mellitus during pregnancy is frequent problem which may cause maternal & fetal complications. Very tight glycemic control is the main requirement for improvement of pregnancy outcome in diabetic ladies.
Insulin is the only approved pharmacological therapy to control hyperglycemia during pregnancy but it has many disadvantage as the fear of injections, hypoglycemia and increased weight. The use of oral therapy to control glycemia during pregnancy if possible would be an excellent alternative to overcome these barriers.
This was randomized controlled trial that included 84 cases with gestational diabetes or NIDDM with pregnancy. All women who agree to participate in the study were randomly allocated into two equal groups.
The 1st group received Glibenclamide/Metformin combination; the beginning dose was 2.5 mg Glibenclamide and 500 mg Metformin orally with the morning meal. The dosage was increased gradually according to blood glucose level to a maximum daily dose of 10 mg Glibenclamide and 2 gm Metformin. The second group received standard insulin therapy in form of subcutaneous two shot combined dose of intermediate acting and short acting insulin given prior to breakfast and dinner.
both groups were comparable at the time of recruitment as regard maternal age (33.19±4.94 versus 32.14±5.73), Number of previous pregnancies (3.72±1.79 versus 3.17±1.98), gestational age (22.14±7.33 versus 24.48±6.33) and glycosylated HbA1c (6.88±0.62 versus 6.96±0.53).
The success of treatment in the present study was defined as the ability of the used medication to control maternal blood glucose, amniotic fluid volume, glycosylated HbA1c, timing of delivery & mode of delivery. Also neonatal outcome was monitored in both groups in form of Birth weight, Fetal umbilical cord blood glucose, Neonatal hypoglycemia, Neonatal jaundice, Admission to neonatal intensive care unit, Duration of admission to NICU, Perinatal mortality and congenital malformation.
Glibenclamide/metformine combination was comparable to insulin treatment as regard mean maternal blood glucose, amniotic fluid volume, glycosylated HbA1c before delivery and reduction in glycosylated HbA1c.
There was no statistically significant difference between two groups as regard fetal birth weight, fetal blood glucose, neonatal jaundice, neonatal hypoglycemia, admission to NICU, duration of admission to NICU, Perinatal mortality and congenital malformations.
The use of the Glibenclamide/metformin combination appears as attractive alternative to traditional insulin treatment in controlling diabetes during pregnancy. It has advantage of being cheaper, more easily to administer.