title: Gestational diabetes mellitus management with oral hypoglycemic agents.
abstract: Oral hypoglycemic agents such as glyburide (second-generation sulfonylurea) and metformin (biguanide) are attractive alternatives to insulin due to lower cost, ease of administration, and better patient adherence. The majority of evidence from retrospective and prospective studies suggests comparable efficacy and safety of oral hypoglycemic agents such as glyburide and metformin as compared to insulin when used in the treatment of women with gestational diabetes mellitus (GDM). Glyburide and metformin have altered pharmacokinetics during pregnancy and both agents cross the placenta. In this article, we review the efficacy, safety, and dosage of oral hypoglycemic agents for the treatment of gestational diabetes mellitus. Additional research is needed to evaluate optimal dosage for glyburide and metformin during pregnancy. Comparative studies evaluating the effects of glyburide and metformin on long-term maternal and fetal outcomes are also needed.
authors.affiliation: Department of Pharmacy, University of Washington, 1959 NE Pacific St, H-375 Health Sciences Center, Box 357630, Seattle, WA 98195-7630.
authors.forename: Rachel J
authors.initials: RJ
authors.lastname: Ryu
authors.affiliation: Department of Pharmacy, University of Washington, 1959 NE Pacific St, H-375 Health Sciences Center, Box 357630, Seattle, WA 98195-7630.
authors.forename: Karen E
authors.initials: KE
authors.lastname: Hays
authors.affiliation: Department of Pharmacy, University of Washington, 1959 NE Pacific St, H-375 Health Sciences Center, Box 357630, Seattle, WA 98195-7630; Department of Obstetrics & Gynecology, University of Washington, Seattle, WA. Electronic address: mhebert@u.washington.edu.
authors.forename: Mary F
authors.initials: MF
authors.lastname: Hebert
mesh_terms: D000284:Administration, Oral; D016640:Diabetes, Gestational / Q000188:drug therapy*; D005260:Female; D005905:Glyburide / Q000008:administration & dosage*; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D007328:Insulin / Q000627:therapeutic use; D008687:Metformin / Q000008:administration & dosage*; D011247:Pregnancy; D011256:Pregnancy Outcome
chemical_list: D007004:Hypoglycemic Agents; D007328:Insulin; D008687:Metformin; D005905:Glyburide
keywords: Gestational diabetes; Glyburide; Hypoglycemic agents; Metformin; Pregnancy outcome