Tratamiento con antidiabéticos orales durante el embarazo en mujeres con diabetes pregestacional. A propósito de un caso

Abstract

Are oral antidiabetic agents an alternative to insulin therapy in pregestational diabetes?Apropos of the case of an Arab immigrant under sulfonylurea treatment until the 20th week of gestation, who delivered a healthy child with no apparent morphologic alterations, we reviewed comparative studies performed in pregnant diabetics treated with oral antidiabetic agents and pregnant diabetic women treated with insulin therapy. Few studies have been performed with oral antidiabetic agents in pregnant women due to the teratogenic potential attributed to these drugs. One study included 404 women randomly assigned between 11 and 13 weeks of gestation to receive glyburide or insulin. No significant differences were found between the two groups in glycemic control, the infants’ length and weight, or neonatal complications. No differences in the incidence of fetal anomalies were observed in the two groups. Therefore, oral antidiabetics may become an effective alternative to insulin therapy in gestational diabetes. However, the use of these drugs is not recommended in clinical guidelines published to date, since further studies are required to determinate their safety and efficacy.