Department of Obstetrics and Gynecology, The University of North Carolina at Chapel Hill, USA.
Best Pract Res Clin Obstet Gynaecol. 2011 Feb;25(1):51-63. doi: 10.1016/j.bpobgyn.2010.10.018. Epub 2011 Jan 19.
With the increase in obesity and sedentary lifestyles, the incidence of diabetes among reproductive-aged women is rising globally. Providers are expected to care for a growing number of women with gestational diabetes (GDM) in the coming decades. Traditionally, insulin has been considered the standard for management of GDM, when diet and exercise fail to achieve tight maternal glucose control without the risk of transfer of insulin across the placenta. Understanding the effectiveness and safety of the use of oral diabetes agents during pregnancy for both maternal and neonatal outcomes as an alternative management option is essential to the care of women with GDM and their offspring. In this review, our objectives were to (1) summarise the available evidence on the efficacy these medications, (2) review available data on adverse effect, (3) discuss current gaps in research, outlining limitations in current study designs that deserve attention and (4) summarise key points for the practicing clinician.
随着肥胖和久坐生活方式的增加，全球生育年龄妇女的糖尿病发病率正在上升。预计在未来几十年，提供者将需要照顾越来越多的患有妊娠期糖尿病（GDM）的女性。传统上，当饮食和运动未能在不增加胰岛素穿过胎盘风险的情况下实现严格的母体血糖控制时，胰岛素被认为是 GDM 管理的标准。了解在妊娠期间使用口服糖尿病药物对母婴结局的有效性和安全性作为替代管理选择对于 GDM 女性及其后代的护理至关重要。在这篇综述中，我们的目标是：(1) 总结这些药物的有效性的现有证据，(2) 回顾不良反应的现有数据，(3) 讨论当前研究中的差距，概述当前研究设计中的局限性，值得关注，以及 (4) 总结临床医生的要点。
