A cautionary response to SMFM statement: pharmacological treatment of gestational diabetes
Use of oral agents to treat gestational diabetes mellitus remains controversial. Recent recommendations from the Society for Maternal-Fetal Medicine assert that metformin may be a safe first-line alternative to insulin for gestational diabetes mellitus treatment and preferable to glyburide. However, several issues should give pause to the widespread adoption of metformin use during pregnancy. Fetal concentrations of metformin are equal to maternal, and metformin can inhibit growth, suppress mitochondrial respiration, have epigenetic modifications on gene expression, mimic fetal nutrient restriction, and alter postnatal gluconeogenic responses.
Source: American Journal of Obstetrics and Gynecology - Category: OBGYN Authors: Linda A. Barbour, Christina Scifres, Amy M. Valent, Jacob E. Friedman, Thomas Buchanan, Donald Coustan, Kjersti Aagaard, Kent L. Thornburg, Patrick M. Catalano, Henry Galan, William W. Hay, Antonio E. Frias, Kartik Shankar, Rebecca A. Simmons, Robert G. M Tags: Viewpoint Source Type: research