Are Oral Hypoglycemic Agents Contraindicated in Pregnancy!

The incidence of gestational diabetes is increasing. There has been a traditional reluctance to recommend oral antidiabetic drugs for the management of hyperglycaemia in gestational diabetes mellitus The medical management of gestational diabetes is still evolving, and recent randomized controlled trials have given a glimse of hope for woman who likes to avoid insulin and prefer oral agents. As insulin therapy is considered the gold standard of pharmacotherapy for gestational diabetes, it becomes a usual recommendation to use it in pregnanacy. The current short acting insulin analogs lispro and aspart are safe, but there are only limited data to support the use of long acting insulin analogs. There are randomized controlled trials which have demonstrated efficacy of the oral agents glyburide and metformin. Whilst short-term data have not demonstrated adverse effects of glyburide and metformin on the fetus, and they are increasingly being used in pregnancy, there remain long-term concerns regarding their potential for harm. This controversy related article gives an overview of the rationale for use of oral antidiabetic agents in the treatment of gestational diabetes.