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Oral Agents for the Treatment of Gestational Diabetes

  • Diabetes and Pregnancy (M-F Hivert and CE Powe, Section Editors)
  • Published:
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Abstract

Purpose of Review

To review the current evidence of the safety and efficacy of the use of oral agents for treatment of gestational diabetes (GDM).

Recent Findings

The use of metformin and glyburide in pregnancy for treatment of GDM has dramatically increased since the early 2000s. Meta-analyses suggest that glyburide may increase the risk for large for gestational (LGA) infants and neonatal hypoglycemia. Conversely, metformin may potentially decrease rates of pregnancy-induced hypertension, LGA, neonatal hypoglycemia, and maternal weight gain. However, recent long-term offspring studies indicate a potential detrimental effect of metformin on fat mass that suggests an effect of such medication on fetal programming. While there have been several novel oral anti-diabetes medications brought to market in the past decade, there is minimal data to guide use and in particular data regarding long-term safety for the exposed offspring of treated women.

Summary

Most professional societies recommend insulin as first-line treatment of gestational diabetes after failure of lifestyle modification. Both metformin and glyburide cross the placenta and long-term safety data is limited. However, patient satisfaction is substantially higher with use of oral agents, and the current literatures suggest that metformin may reduce several common short-term adverse outcomes related to GDM.

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Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, The Ohio State University College of Medicine, 395 W 12th Ave., Columbus, OH, USA

    Matthew M. Finneran & Mark B. Landon

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  1. Matthew M. Finneran
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Correspondence to Matthew M. Finneran.

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Matthew M. Finneran and Mark B. Landon declare that they have no conflict of interest.

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This article is part of the Topical Collection on Diabetes and Pregnancy

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Finneran, M.M., Landon, M.B. Oral Agents for the Treatment of Gestational Diabetes. Curr Diab Rep 18, 119 (2018). https://doi.org/10.1007/s11892-018-1093-2

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