Varughese Maria S, O'Mahony Fidelma, Varadhan Lakshminarayanan
University of Sheffield Medical School, Royal Hallamshire Hospital, Sheffield S10 2RX, South Yorkshire, UK.
Department of Obstetrics & Gynaecology, University Hospitals of North Midlands NHS Trust, Stoke-on-Trent, UK; School of Medicine, Faculty of Health, Keele University, North Staffordshire, UK.
Clin Med (Lond). 2025 Mar;25(2):100298. doi: 10.1016/j.clinme.2025.100298. Epub 2025 Feb 22.
The prevalence of type 2 diabetes mellitus (T2DM) and obesity is increasing in young adults, posing significant risks around pregnancy. Obesity also impacts on fertility and the co-existence of polycystic ovarian syndrome increases the prevalence of cardiovascular metabolic risk factors. There has been a renewed interest in glucagon-like peptide-1 receptor agonists (GLP-1RA) in this context, due to their multi-dimensional impact on the reproductive axis, as well as their ability to simultaneously target weight loss and glycaemic control. There is, however, limited availability of safety data with respect to these newer non-insulin-based diabetes medications from the perspective of fetal development. As GLP-1RA are not licensed for use in pregnancy, with the increasing chances of incidental exposure from pre-conception use for obesity and T2DM, it is imperative that pre-conception counselling should be an integral part of consultation prior to the initiation of these drugs.
2型糖尿病（T2DM）和肥胖症在年轻成年人中的患病率正在上升，给妊娠带来重大风险。肥胖还会影响生育能力，而多囊卵巢综合征的并存会增加心血管代谢危险因素的患病率。在这种情况下，人们对胰高血糖素样肽-1受体激动剂（GLP-1RA）重新产生了兴趣，因为它们对生殖轴有多方面的影响，并且能够同时针对体重减轻和血糖控制。然而，从胎儿发育的角度来看，关于这些新型非胰岛素类糖尿病药物的安全性数据有限。由于GLP-1RA未被批准用于妊娠，且因肥胖症和T2DM在受孕前使用而意外接触的机会增加，因此孕前咨询应成为开始使用这些药物之前咨询的一个组成部分，这一点至关重要。
