GESTATIONAL DIABETES MELLITUS: A REVIEW OF THERAPEUTIC OPTIONS

Abstract

Gestational diabetes mellitus (GDM) is the most common medical complication of pregnancy. Its treatment can prevent short-term maternal and neonatal complications. The main goal of GDM treatment is to achieve maternal normoglycemia. Initial treatment includes lifestyle modification, especially nutritional modification, and the inclusion of physical activity. Most women with GDM require pharmacological therapy to control their blood glucose levels. Insulin has traditionally been the most recommended treatment if maternal glucose levels remain high with dietary changes. In addition to insulin therapy, there is oral pharmacotherapy, which is still an emblematic topic in the medical literature, due to issues related to efficacy and safety, particularly in the long term, due to placental transfer to the fetus. Thus, insulin should be used preferably over oral medications, such as metformin and glibenclamide, to reduce blood glucose levels. Based on the available data, metformin may be an effective treatment for GDM, but long-term data on outcomes in offspring of patients with GDM treated with metformin are still lacking. Clinicians should carefully consider the clinical presentation of patients when selecting different treatment strategies for GDM. Therefore, we conducted a literature review discussing current data regarding the treatment of GDM.