title: Oral hypoglycemic agents for gestational diabetes mellitus?
abstract: BACKGROUND
  Gestational diabetes mellitus (GDM), the most frequent medical complication of pregnancy, is associated with several adverse outcomes over the short- and long-term for both mother and offspring. Standard treatment for GDM consists of insulin injections. Oral hypoglycemic agents (OHAs), on the other hand, are still the subject of controversy. Although OHAs are seemingly as efficient as insulin and may provide better quality of life, congenital malformations and unknown long-term effects are still feared.
  
  
  METHODS
  Recent data on the pharmacokinetics of two OHAs (glyburide and metformin) and their clinical use for GDM are reviewed, with a focus on clinical trials and observational studies comparing insulin with glyburide or metformin (1960 - 2010). The review will provide a comprehensive overview of the pros and cons of OHA usage, an appreciation of OHAs' efficiency for the purpose of controlling glycemia and embryogenetic basics relating to congenital malformations.
  
  
  CONCLUSIONS
  While insulin treatment is an effective therapy for controlling maternal glycemia, it nevertheless requires sufficient education and skills on the part of the patient to manage properly and may cause hypoglycemia, fear and anxiety. Oral treatment as a more user-friendly alternative may thus facilitate the control of GDM in some patients.
authors.affiliation: Division of Endocrinology, Department of Medicine, Centre Hospitalier Universitaire de Sherbrooke, 3001, 12th Avenue North, Sherbrooke (Québec) J1H 5N4, Canada.
authors.forename: Ana Cristina
authors.initials: AC
authors.lastname: Maymone
authors.forename: Jean-Patrice
authors.initials: JP
authors.lastname: Baillargeon
authors.forename: Julie
authors.initials: J
authors.lastname: Ménard
authors.forename: Jean-Luc
authors.initials: JL
authors.lastname: Ardilouze
mesh_terms: D000284:Administration, Oral; D000818:Animals; D016640:Diabetes, Gestational / Q000188:drug therapy* / Q000503:physiopathology; D005260:Female; D005905:Glyburide / Q000008:administration & dosage / Q000493:pharmacokinetics / Q000627:therapeutic use*; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage / Q000493:pharmacokinetics / Q000627:therapeutic use*; D007328:Insulin / Q000627:therapeutic use; D008687:Metformin / Q000008:administration & dosage / Q000493:pharmacokinetics / Q000627:therapeutic use*; D011247:Pregnancy; D011788:Quality of Life
chemical_list: D007004:Hypoglycemic Agents; D007328:Insulin; D008687:Metformin; D005905:Glyburide