6533b7cefe1ef96bd12570ab

RESEARCH PRODUCT

Pharmacotherapy for gestational diabetes

Angelo Maria PattiRosaria Vincenza GiglioNikolaos PapanasKalliopi PafiliManfredi Rizzo

subject

medicine.medical_specialtyinsulinlifestyleendocrine system diseasesmedicine.medical_treatment030209 endocrinology & metabolismCarbohydrate metabolism03 medical and health sciences0302 clinical medicineInsulin resistancePharmacotherapyPregnancyInternal medicineHumansMedicineHypoglycemic AgentsPharmacology (medical)030212 general & internal medicineDipeptidyl-Peptidase IV InhibitorsPharmacologyDipeptidyl-Peptidase IV InhibitorsPregnancytherapybusiness.industryInsulinnutritional and metabolic diseasesGeneral Medicinemedicine.diseaseincretinPregnancy ComplicationPregnancy ComplicationsGestational diabetesDiabetes GestationalEndocrinologyGestational diabeteDipeptidyl-Peptidase IV InhibitorFemalebusiness

description

Introduction: Gestational diabetes mellitus (GDM) represents impaired carbohydrate metabolism during pregnancy and is characterized by progressive insulin resistance and compensatory hyperinsulinaemia. If inadequately treated, it may lead to fetal macrosomia and other adverse outcomes. Areas covered: In this review, the authors summarize the current evidence from studies on the use of insulin and other agents for the treatment of women with GDM. Expert opinion: Lifestyle management is of paramount importance for the treatment of GDM. In pharmacotherapy, insulin remains the long-established mainstay of treatment. NPH (Neutral Protamine Hagedorn) and soluble human insulin have long been established for use, but favorable experience has now also accumulated with the newer insulins (aspart, lispro, detemir). Alternatively, metformin and glyburide have been used in GDM, but they have never gained wide acceptance. Nutritional supplements based on micronutrients and bioactives (probiotics and myoinositol) have shown promising results as well. Further experience with incretin agents (DPP-4 inhibitors and GLP-1 receptor agonists) is awaited.

yearjournalcountryeditionlanguage
2018-08-23
10.1080/14656566.2018.1509955http://hdl.handle.net/10447/433782