People with gestational diabetes may also need to take oral medications (metformin) if changes in diet and exercise don't help enough to keep their blood sugar levels within range. Metformin is taken in tablet form. It makes the body respond better to insulin, which is the hormone that lowers the level of glucose in the blood. If diet and exercise aren't enough to control blood sugar levels, you may need insulin injections to lower your blood sugar. A small number of women with gestational diabetes need insulin to reach their blood sugar goals.
Some healthcare providers prescribe an oral medication to control blood sugar levels. Other healthcare providers believe that more research is needed to confirm that oral medications are as safe and effective as injectable insulin in controlling gestational diabetes. Administering an oral antidiabetic agent instead of insulin seems tempting, but there is little data on fetal exposure to the mother's OAA during pregnancy and during breastfeeding. In a meta-analysis (10 studies in 471 women exposed to sulfonylureas and biguanides in the first trimester), no significant difference was found in the rate of serious malformations or neonatal death between women exposed in the first trimester to oral antidiabetic agents compared to women who were not exposed.
This review aims to provide an evidence-based approach, consistent with basic pharmacological and clinical knowledge, that helps physicians to use oral antidiabetic agents in a rational and pragmatic manner. The appropriate selection of ideal candidates is critical to achieving clinical success with the use of these drugs in the treatment of diabetes mellitus. Adding a medication with this particular set of side effects to a state of pregnancy can be problematic from the standpoint of patient satisfaction and may limit compliance with the care plan. If you're at high risk of diabetes, for example, if you're overweight or obese before pregnancy; if you have a mother, father, brother, or child with diabetes; or if you had gestational diabetes during a previous pregnancy, your healthcare provider may test you for diabetes early in your pregnancy, probably at your first prenatal visit.
The Pubmed search was conducted using the terms “Diabetes” and “Pregnancy” and “Glyburide”; “Diabetes” and “Pregnancy”, “Diabetes” and “Pregnancy” and “Metformin”. Oral medications are attractive options for patients, given their ease of administration, lower cost, comparable efficacy, and better adherence (. Home > PregnancyHub > Pregnancy Complications > Gestational Diabetes > Taking Medication and Insulin for Diabetes gestational. Oral antidiabetic agents (OAA) have been investigated as an alternative to insulin therapy because of their ease of use and lower cost.
There were no significant differences between the two groups in terms of the percentage of deliveries by caesarean section, gestational age at delivery, the number of newborns with neonatal hypoglycemia, admission to the intensive care unit and perinatal death. There were no significant differences between the two groups in terms of the average level of HbA1c% between 36 and 37 weeks of pregnancy. The American Dental Association (ADA) does not recommend the use of oral antidiabetic drugs during pregnancy, while guidelines from the United Kingdom's National Institute for Health and Care Excellence (NICE) consider that metformin and glyburide are safe during pregnancy and breastfeeding. As a result, the prevalence of overt diabetes during pregnancy and glucose intolerance during pregnancy (gestational diabetes mellitus) has also increased.
