What anti-diabetic drugs are safe and effective in treating gestational diabetes?

This study investigated the safety and effectiveness of different drugs used to treat gestational diabetes.

They found that metformin (Glucophage) is associated with fewer pregnancy complications than glyburide (Glynase), however it is less effective at managing blood sugar levels. 

Gestational diabetes (GDM) is a condition where pregnant women develop glucose intolerance, leading to elevated blood glucose during the pregnancy. This can have negative effects on both the mother and child. In order to manage GDM, most women are advised to alter their diet or increase exercise.

For some patients diet and exercise do not effectively manage blood glucose level. Medications may be required. The safety and effectiveness of anti-diabetic drugs in pregnant women has been studied, however in many cases these studies investigated one or compared two treatments. 

This study reviewed data from clinical trials, comparing all treatments and ranking the medications based on effectiveness and adverse outcomes in GDM. 

This study included data from 32 clinical trials. Maternal outcomes of interest included blood glucose control, weight gain and pre-eclampsia. Neonatal (infant) outcomes included large birth weight, hypoglycemia and jaundice. Anti-diabetic drugs were then ranked based on the effectiveness and adverse outcomes.

Metformin was associated with fewer negative neonatal outcomes compared to insulin or glyburide. Glyburide has a greater rate of glucose control but is associated with more adverse outcomes for both mother and child. These included pre-eclampsia, jaundice, and higher birth weight.

This study concluded that metformin is associated with fewer adverse outcomes than glyburide, however it is less effective at managing blood sugar levels.

There are other factors which may influence the effectiveness of treatment and risk of adverse outcomes. Some of these could not be incorporated into this type of analysis. Only oral anti-diabetic drugs and insulin were investigated, there are other effective diabetes medications. 

If you have any concerns regarding gestational diabetes management, please discuss with your physician.