Rickert Michaela, Caughey Aaron B, Valent Amy M
Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, School of Medicine.
Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, School of Medicine.
Obstet Gynecol Clin North Am. 2023 Mar;50(1):121-136. doi: 10.1016/j.ogc.2022.10.007.
Persons with gestational and pregestational diabetes during pregnancy may require pharmacologic agents to achieve pregnancy glycemic targets, and the available medications for use in pregnancy are limited. Insulin is the only FDA-approved medication for use in pregnancy and has the greatest evidence for safety and efficacy. Metformin and glyburide are the most commonly used oral agents in pregnancy. Understanding each medication's unique pharmacokinetics, potential side effects, fetal or childhood risks, gestational age of medication initiation and patient's diabetes care barriers are important aspects of shared decision-making and choosing a regimen that will achieve glycemic and pregnancy goals.
孕期患有妊娠期糖尿病和孕前糖尿病的患者可能需要使用药物来实现孕期血糖目标，而可用于孕期的药物有限。胰岛素是唯一经美国食品药品监督管理局（FDA）批准用于孕期的药物，并且在安全性和有效性方面有最充分的证据。二甲双胍和格列本脲是孕期最常用的口服药物。了解每种药物独特的药代动力学、潜在副作用、对胎儿或儿童的风险、开始用药的孕周以及患者糖尿病护理的障碍，是共同决策和选择能够实现血糖及孕期目标方案的重要方面。
