Kavitha Nagandla, De Somsubhra, Kanagasabai Sachchithanantham
Department of Obstetrics and Gynecology, Melaka Manipal Medical College, Jalan Batu Hampar, 75150 Bukit Baru, Melaka Malaysia.
J Obstet Gynaecol India. 2013 Apr;63(2):82-7. doi: 10.1007/s13224-012-0312-z. Epub 2013 Mar 27.
Traditionally, insulin has been the gold standard in the management of Type 2 diabetes in pregnancy and gestational diabetes. However, insulin therapy can be inconvenient because of the needs for multiple injections, its associated cost, pain at the injection site, need for refrigeration, and skillful handling of the syringes. This has led to the exploration of oral hypoglycemic agents as an alternative to insulin therapy.
This review examines and evaluates the evidences on the efficacy, safety, and current recommendations of oral hypoglycemic agents.
The evidence of this study supports the use of glyburide and metformin in the management of Type 2 diabetes and gestational diabetes with no increased risk of neonatal hypoglycemia or congenital anomalies. The safety of these oral hypoglycemic agents are limited to the prenatal period and more randomized controlled trials are required to provide information on the long-term follow up on neonatal and cognitive development.
传统上,胰岛素一直是治疗妊娠2型糖尿病和妊娠期糖尿病的金标准。然而,胰岛素治疗可能不方便,因为需要多次注射、相关费用、注射部位疼痛、需要冷藏以及熟练操作注射器。这导致了对口服降糖药作为胰岛素治疗替代方案的探索。
本综述审查并评估关于口服降糖药的疗效、安全性及当前推荐的证据。
本研究的证据支持使用格列本脲和二甲双胍治疗2型糖尿病和妊娠期糖尿病,且新生儿低血糖或先天性异常风险不会增加。这些口服降糖药的安全性仅限于孕期,需要更多随机对照试验来提供有关新生儿和认知发育长期随访的信息。