Drugs to Control Diabetes During Pregnancy

Abstract

Diabetes is a common complication of pregnancy associated with both short- and long-term adverse maternal and offspring effects. All types of diabetes in pregnancy are increasing in prevalence. Treatment of diabetes in pregnancy, targeting glycemic control, improves both maternal and offspring outcomes, albeit imperfectly for many women. Pharmacologic treatment recommendations differ between pregestational and gestational diabetes. Improved treatment of diabetes in pregnancy will need to consider maternal disease heterogeneity and comorbidities as well as long-term offspring outcomes. In this review, the authors summarize recent clinical studies to highlight established pharmacologic treatments for diabetes in pregnancy and provide suggestions for further research.

Keywords: Diabetes; Glucose; Insulin; Pregnancy.

Figure 1:. Longitudinal changes in insulin sensitivity.

Changes in insulin sensitivity in the pregravid, early pregnancy (12–14 weeks) and late pregnancy (34–36 weeks) period is shown in women with normal glucose tolerance based on hyperinsulinemic-euglycemic clamps. (mean ± SD; p-values are shown based on ANOVA).

Figure 2:. Longitudinal changes in insulin response.

Changes in insulin response in the pregravid, early pregnancy (12–14 weeks) and late pregnancy (34–36 weeks) period is shown in women with normal glucose tolerance based on first phase insulin response to an intravenous glucose tolerance test (0–10 min). (mean ± SD; p-values are shown based on ANOVA).