Gestational Diabetes Mellitus Pharmacological Prevention and Treatment

Abstract

Gestational diabetes mellitus (GDM) is one of the most common medical complications of pregnancy and is defined as glucose intolerance that first emerges or is first recognized during pregnancy. Several factors increase the risk of a pregnant woman developing gestational diabetes mellitus, and several interventions have been tested for the prevention of GDM development. The most common pharmacological interventions that have been assessed are metformin administration, probiotics administration, and vitamin D administration. However, no intervention appears to be universally superior to placebo/no intervention for the prevention of GDM. Administration of insulin is the preferred medication for treating hyperglycemia in gestational diabetes mellitus. Metformin and glyburide are not regarded as first-line agents, as both cross the placenta to the fetus. Even though there are sufficient data indicating that administration of metformin is safe and effective in women with GDM, there are very limited data concerning the long-term effects of metformin on the offspring. Furthermore, glyburide should be used with caution, as it increases the risk of neonatal hypoglycemia. Some studies also show that it increases the risk of macrosomia. Overall, oral agents may be a therapeutic option in women with GDM after a discussion of the known risks and the need for more long-term safety data in the offspring. The present review aims to highlight the current scientific status regarding the prevention and treatment of GDM.