Pharmacotherapy for hyperglycemia in pregnancy – Do oral agents have a place?

Rosa Corcoy, Montserrat Balsells, Apolonia García-Patterson, Anat Shmueli, Eran Hadar

Research output: Contribution to journalReview articleResearchpeer-review

6 Citations (Scopus)

Abstract

© 2018 Elsevier B.V. Diabetes is a frequent condition in pregnancy and achieving adequate glycemic control is of paramount importance. Insulin treatment is the gold standard, oral agents are more attractive, but their safety and efficiency should be a prerequisite for their use. We have more information regarding treatment of women with gestational diabetes mellitus where glyburide can induce a picture of fetal hyperinsulinism (higher birthweight and more neonatal hypoglycemia) whereas metformin requires supplemental insulin in a larger proportion of women but achieves satisfactory perinatal outcomes with the exception of preterm birth. Information in patients with Type 2 Diabetes Mellitus is much more limited but also favors metformin. Combinations provide additional possibilities. However, as to long-term outcomes, we have no information on the impact of exposure to glyburide and it is still unclear if in utero exposure to metformin will have any effect on the offspring and the direction of this effect. Women prefer oral agents, indicating the need of additional studies.
Original languageEnglish
Pages (from-to)51-58
JournalDiabetes Research and Clinical Practice
Volume145
DOIs
Publication statusPublished - 1 Nov 2018

Keywords

  • Acarbose
  • Gestational diabetes mellitus
  • Glyburide
  • Insulin
  • Metformin
  • Type 2 diabetes mellitus

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