School of Medicine and Surgery, University of Milano-Bicocca, Via Pergolesi 33, 20900 Monza, Italy.
Department of Epidemiology, Lazio Regional Health Service, ASL Roma 1, 00147 Rome, Italy.
Int J Environ Res Public Health. 2023 Dec 4;20(23):7139. doi: 10.3390/ijerph20237139.
Pregestational and gestational diabetes mellitus are relevant complications of pregnancy, and antidiabetic drugs are prescribed to obtain glycemic control and improve perinatal outcomes. The objective of this study was to describe the prescription pattern of antidiabetics before, during and after pregnancy in Italy and to evaluate its concordance with the Italian guideline on treatment of diabetes mellitus. A multi-database cross-sectional population study using a Common Data Model was performed. In a cohort of about 450,000 women, the prescribing profile of antidiabetics seemed to be in line with the Italian guideline, which currently does not recommend the use of oral antidiabetics and non-insulin injection, even if practice is still heterogeneous (up to 3.8% in the third trimester used oral antidiabetics). A substantial variability in the prescription pattern was observed among the Italian regions considered: the highest increase was registered in Tuscany (4.2%) while the lowest was in Lombardy (1.5%). Women with multiple births had a higher proportion of antidiabetic prescriptions than women with singleton births both in the preconception period and during pregnancy (1.3% vs. 0.7%; 3.4% vs. 2.6%) and used metformin more frequently. The consumption of antidiabetics in foreign women was higher than Italians (second trimester: 1.8% vs. 0.9%, third trimester: 3.6% vs. 1.8%).
妊娠前和妊娠期间糖尿病是妊娠的相关并发症，会开处方使用降糖药物以控制血糖并改善围产期结局。本研究的目的是描述意大利妊娠前、妊娠期间和产后抗糖尿病药物的处方模式，并评估其与意大利糖尿病治疗指南的一致性。使用通用数据模型进行了一项多数据库的横断面人群研究。在约 450,000 名女性的队列中，抗糖尿病药物的处方模式似乎符合意大利指南，该指南目前不推荐使用口服抗糖尿病药物和非胰岛素注射，即使实践仍存在异质性（高达 3.8%的患者在妊娠晚期使用口服抗糖尿病药物）。在所考虑的意大利地区中，观察到处方模式存在很大的可变性：托斯卡纳（Tuscany）的增幅最高（4.2%），而伦巴第（Lombardy）的增幅最低（1.5%）。与单胎妊娠相比，多胎妊娠的女性在妊娠前和妊娠期间使用抗糖尿病药物的比例更高（前三个月 1.3%比 0.7%；后三个月 3.4%比 2.6%），并且更频繁地使用二甲双胍。外国女性使用抗糖尿病药物的比例高于意大利人（妊娠中期：1.8%比 0.9%；妊娠晚期：3.6%比 1.8%）。
