Evaluation of Safety and Efficacy of Oral Antidiabetic Medication in Gestational Diabetes: A Systematic Review.

Objective: The prevalence of diabetes mellitus (DM) in pregnancy is increasing which may be due to gestational diabetes (diagnosed in second or third trimester) or pre-existing DM like type2. The aim of this systematic review was to discuss the safety and efficacy of the oral anti-diabetic medications in pregnant women. Materials and Methods: Primary and secondary search strategies were used. PubMed, Cochrane and Scopus, EMBASE were used. The search was made using medical subject headings (MeSH) "Diabetes and/or Pregnancy", "Treatment with/and Metformin", "Glyburide and Effectiveness", "Safety and/or Malformations", "Diabetes and/or Teratogenicity". Results: Metformine comparing to the other drugs from the different OAD was the safest drug as it has the less neonatal hypoglycemia affect, lowest risk to develop neonatal malformation, lower rate of gestational hypertension and lower postprandial blood glucose. Also metformine does not cause any alteration in embryonic, no major malformations and no teratoginic effect. Moreover patients on glyburide had significantly higher weight gain compared to patients on metformin. Conclusion: Metformin was found to be effective and the safest option among others with weight benefits for obese and nonobese patients. Also, combining glyburide with metformin can give better glycemic control and better efficacy rate. [ABSTRACT FROM AUTHOR]