PERBANDINGAN EFIKASI METFORMIN VERSUS INSULIN PADA MANAJEMEN DIABETES MELITUS GESTASIONAL: TINJAUAN SISTEMATIS
DOI:
https://doi.org/10.31004/joecy.v6i1.6903Keywords:
Diabetes Gestational, Insulin, Metformin, Preeclampsia, Systematic ReviewAbstract
Latar Belakang: Diabetes Melitus Gestasional (DMG) semakin prevalen di Indonesia akibat transisi epidemiologi metabolik, dengan insulin sebagai standar emas namun terkendala biaya dan kepatuhan. Metformin muncul sebagai alternatif oral potensial. Tujuan: Menganalisis efikasi kontrol glikemik, luaran maternal, dan keamanan neonatal metformin versus insulin pada DMG. Jenis dan Metode Penelitian: Tinjauan sistematis mengikuti PRISMA 2020. Populasi dan Sampel: Ibu hamil DMG dari RCT 2015-2026 di PubMed, Scopus, Cochrane. Instrumen dan Teknik Analisis Data: Kerangka PICO, RevMan untuk meta-analisis (RR, SMD, 95% CI), RoB 2, GRADE. Hasil: Metformin non-inferior pada HbA1c/GDP, menurunkan berat badan gestasional (SMD -1,05 kg hingga -1,28 kg), preeklamsia (RR 0,61; 95% CI 0,48-0,78), hipoglikemia neonatal (RR 0,72), NICU (RR 0,75). Kesimpulan: Metformin superior secara manfaat-risiko dan cost-effective untuk JKN Indonesia, direkomendasikan lini pertama pada DMG ringan-sedang.
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