Medications for Gestational Diabetes

Gestational diabetes is when diabetes occurs in non-diabetic women while pregnant. The diabetes usually begins in the 5th to 6th month of the pregnancy and usually quickly disappears soon after delivery.

Some women are able to control this diabetes with exercise and diet alone but others do need medication. There are even some women who will need oral medication as well as insulin injections.

The 2 oral medications which are most commonly considered in treating gestational diabetes are metformin (Glumetza, Fortamet, Glucophage, and Riomet) and glyburide (Glynase, Micronase, and Diabeta).

Metformin

Metformin works by decreasing the amount of glucose or sugar which the liver produces which keeps the blood glucose level low and also boosts the body’s insulin response. Metformin is a medication which is typically used for the treatment of Type-2 diabetes.

Glyburide

This medication is taken orally and is also used in treating Type 2 diabetes. Glyburide mechanism is to stimulate the pancreas which is the organ that creates insulin. This Insulin is needed to help the cells absorb and use energy from the food that is eaten. This keeps your level of blood glucose in the normal range.

Oral medications are prescribed either alone or to be used along with insulin. Much controversy has been debated about using oral diabetes medications during pregnancy, so glyburide and metformin are only used in those cases where diet, exercise and insulin are not working at controlling the blood glucose levels.

The 2 medications have yet to be approved by the Food and Drug Administration (FDA) for use in gestational diabetes. Opinions about these medications seems to be varying as more research studies are finished, The controversy is not whether these medications are effective in controlling the disease but instead the debate centers on whether or not these medications harm the pregnancy or the fetus in any way.

Doctors are understandably very cautious about prescribing any drugs to women who are pregnant. This is because of any complications for the fetus. Here are a few of the issues which go into deciding if a medication which is oral needs to be added:

Metformin crosses the placenta in small doses

Even if metformin does cross the placenta and enters the baby’s blood system, the amount which crosses is small. Studies have not shown evidence that metformin damages the fetus.

Glyburide doesn’t cross the placenta

With insulin the medication stays in the mother’s blood system and doesn’t enter the blood system of the fetus which is a good feature in medications which pregnant women must take. Likewise glyburide does not cross the placenta in any great amount.

Use during 1st trimester

A diagnosis of gestational diabetes normally does not occur until near the last month of the 2nd or the first month of the 3rd trimester. This minimizes the risk from these medications because they are not being taken during the critical times when the fetus’s organs are being formed.

Medication compliance

There is a study that shows that women are happier with treatment by oral medication than those women who need to take insulin. This is because insulin can only be administered thru injections as metformin and glyburide are medications which are taken by mouth. This usually leads to much better compliance.

For any women with gestational diabetes, it is major to having a safe, healthy pregnancy to keep the blood glucose level in the normal range. When gestational diabetes is not controlled it can lead to complications with the delivery and adds to the chances of having to have a caesarean section. Research has shown that this also puts mother and baby at greater risks for developing Type 2 diabetes at some time in the future.