The incidence of gestational diabetes is increasing. Therehas been a traditional reluctance to recommend oralantidiabetic drugs for the management of hyperglycaemiain gestational diabetes mellitus The medical managementof gestational diabetes is still evolving, and recentrandomized controlled trials have given a glimse of hopefor woman who likes to avoid insulin and prefer oral agents..As insulin therapy is considered the gold standard ofpharmacotherapy for gestational diabetes, it becomes ausual recommendation to use it in pregnanacy. The currentshort acting insulin analogs lispro and aspart are safe, butthere are only limited data to support the use of long actinginsulin analogs. There are randomized controlled trialswhich have demonstrated efficacy of the oral agentsglyburide and metformin. Whilst short-term data have notdemonstrated adverse effects of glyburide and metforminon the fetus, and they are increasingly being used inpregnancy, there remain long-term concerns regarding theirpotential for harm. This controversy related article givesan overview of the rationale for use of oral antidiabeticagents in the treatment of gestational diabetes.DOI: 10.3329/jbcps.v28i2.5376J Bangladesh Coll Phys Surg 2010; 28: 129-131
展开▼
