Diabetes: how to manage gestational diabetes mellitus

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Abstract

Due to worldwide increases in obesity and average maternal age, the incidence of gestational diabetes mellitus (GDM) is increasing. The primary treatment of GDM is medical nutrition therapy but approximately 15–30% of individuals need pharmacotherapy to reach blood glucose goals to minimize the adverse consequences of hyperglycaemia. In the past, regular and neutral protamine Hagedorn insulin were the mainstays of pharmacological treatment for GDM due to their well-established safety; however, because they are administered as injections and require strict timing of doses and meals to minimize hypoglycaemia, alternatives are often sought. The research around the treatment of GDM continues to evolve as insulin analogues and oral agents are studied in clinical trials. The short-term and long-term effects of treatment choices on both mothers and progeny are being evaluated, and this narrative review summarizes the current state of information available regarding the treatment of GDM.

Keywords: gestational diabetes, insulin, metformin, nutrition therapy, pregnancy.

Citation: Mukherjee SM, Dawson A. Diabetes: how to manage gestational diabetes mellitus. Drugs Context. 2022;11:2021-9-12. https://doi.org/10.7573/dic.2021-9-12

Contributions: SMM conceived and designed the structure of the article, identified articles for inclusion, synthesized available published research data and wrote several sections of the paper. AD identified articles for inclusion, synthesized available published research data and wrote several sections of the paper. All authors contributed equally to the preparation of this manuscript. All named authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship for this article, take responsibility for the integrity of the work as a whole and have given their approval for this version to be published.

Disclosure and potential conflicts of interest: The authors declare that they have no conflicts of interest relevant to this manuscript. The International Committee of Medical Journal Editors (ICMJE) Potential Conflicts of Interests form for the authors is available for download at: https://www.drugsincontext.com/wp-content/uploads/2022/01/dic.2021-9-12-COI.pdf

Acknowledgements: None.

Funding declaration: The authors received no funding for this paper.

Copyright: Copyright © 2022 Mukherjee SM, Dawson A. Published by Drugs in Context under Creative Commons License Deed CC BY NC ND 4.0 which allows anyone to copy, distribute and transmit the article provided it is properly attributed in the manner specified below. No commercial use without permission.

Correct attribution: Copyright © 2022 Mukherjee SM, Dawson A. https://doi.org/10.7573/dic.2021-9-12. Published by Drugs in Context under Creative Commons License Deed CC BY NC ND 4.0.

Article URL: https://www.drugsincontext.com/diabetes-how-to-manage-gestational-diabetes-mellitus

Correspondence: S Mimi Mukherjee, MCPHS University School of Pharmacy, 19 Foster St, Worcester, MA 01608, USA. Email: mimi.mukherjee@mcphs.edu

Provenance: Invited; externally peer reviewed.

Submitted: 28 September 2021; Accepted: 3 January 2022; Publication date: 14 June 2022.

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