[Oral blood glucose-lowering medication as a monotherapy in gestational diabetes: a hotly debated topic].

Treatment of gestational diabetes mellitus is a hotly debated topic. In a recent randomized trial, metformin as a monotherapy achieved maternal and neonatal outcomes comparable to insulin treatment. In 2000, a randomized trial reported a similar favourable result with glibenclamide. The logical conclusion would be that either drug could already have a place in the usual treatment strategy in gestational diabetes. However, a number of major methodological, design and interpretation issues and shortcomings have led to the conclusion that such a point of view is not currently tenable. Therefore, neither metformin nor glibenclamide can yet have an established place as monotherapies in gestational diabetes; they can be used only in exceptionally cases.