{ "schemaVersion": 2, "eyebrow": "Obstetric Endocrinology", "title": "Gestational Diabetes", "summary": "Gestational diabetes requires timely glucose-based diagnosis, nutrition and activity treatment, escalation to pharmacotherapy when glycemic targets are not met, and postpartum surveillance for type 2 diabetes risk. Treatment reduces important perinatal complications, while medication selection requires individualized maternal and fetal tradeoffs.", "seoDescription": "Point-of-care approach to gestational diabetes screening, glucose testing, treatment escalation, insulin versus oral agents, and postpartum diabetes risk.", "clinicalQuestion": "How should clinicians diagnose, treat, and follow gestational diabetes to reduce maternal and neonatal risk?", "specialty": "Obstetrics and Gynecology", "audience": "U.S. physicians and medical trainees", "tags": [ "gestational diabetes mellitus", "GDM screening", "oral glucose tolerance test", "insulin in pregnancy", "metformin in pregnancy", "postpartum diabetes screening" ], "keyTakeaways": [ "Use an oral glucose tolerance test-based strategy for gestational diabetes assessment; 75-g and 100-g glucose loads are established diagnostic approaches. [5]", "Treating gestational diabetes improves perinatal outcomes; randomized trials evaluated treatment against routine care in women with gestational diabetes. [4]", "For patients requiring medication, insulin remains a nonplacental injectable option; metformin and glyburide are oral alternatives with distinct maternal, neonatal, and long-term tradeoffs. [11][20][23]", "Poor glycemic control during pregnancy is associated with diabetic ketoacidosis, preeclampsia, pregnancy loss, preterm delivery, macrosomia-related morbidity, stillbirth, and major birth defects. [2]", "A history of gestational diabetes confers an approximately 10-fold higher risk of later type 2 diabetes than normoglycemia in pregnancy. [21]" ], "sections": [ { "id": "screening-and-diagnostic-pathway", "eyebrow": "Diagnosis", "heading": "Use glucose testing to establish gestational diabetes", "intro": "Choose and document a glucose-load protocol so diagnostic interpretation is reproducible across prenatal care.", "paragraphs": [ "Screening and diagnostic pathways rely on oral glucose testing. During an OGTT, obtain a fasting plasma glucose, administer either a 75-g or 100-g glucose load, and measure glucose at protocol-defined post-load intervals. [5]", "Apply the same laboratory protocol used by the delivering institution and diabetes-in-pregnancy service rather than mixing criteria from different testing strategies. The clinical consequence of a positive result is intensified glycemic management intended to reduce perinatal complications. [4][5]", "Do not treat early-pregnancy hyperglycemia as interchangeable with conventional gestational diabetes without determining whether overt preexisting diabetes is present. Evidence on whether treatment of gestational diabetes diagnosed before 20 weeks improves maternal and infant outcomes remains uncertain, so early diagnosis should trigger individualized risk assessment and coordinated obstetric-diabetes management. [3]" ], "bullets": [ "Record gestational age at testing, fasting status, glucose-load dose, sampling times, and all plasma glucose values in the obstetric record. [5]", "At diagnosis, assess whether hyperglycemia is severe enough to raise concern for pregestational diabetes and whether symptoms or illness warrant evaluation for ketosis. Poorly controlled diabetes increases the risk of diabetic ketoacidosis in pregnancy. [2]" ], "subsections": [], "table": { "caption": "Glucose-load testing formats used in gestational diabetes assessment. [5]", "columns": [ "Test format", "Required measurements", "Clinical use" ], "rows": [ [ "75-g OGTT", "Fasting glucose followed by glucose assessment after a 75-g load. [5]", "A glucose-load diagnostic format; use the institution's specified interpretation criteria. [5]" ], [ "100-g OGTT", "Fasting glucose followed by glucose assessment after a 100-g load. [5]", "A glucose-load diagnostic format; use the institution's specified interpretation criteria. [5]" ] ] } }, { "id": "initial-management-and-monitoring", "eyebrow": "Initial Management", "heading": "Start structured lifestyle treatment and glucose monitoring immediately", "intro": "Use glucose data to determine whether nutrition and activity measures are sufficient or medication is needed.", "paragraphs": [ "Initiate structured nutrition counseling, physical activity planning, and home glucose monitoring after diagnosis. Lifestyle interventions in gestational diabetes commonly target nutrition and physical activity, although intervention effects vary across programs and populations. [9]", "Review glucose logs at defined follow-up intervals and distinguish fasting from postprandial excursions before selecting medication. A predominantly fasting pattern generally requires a strategy that addresses overnight or basal glycemia, whereas isolated meal-related excursions require therapy aligned with meals; the practical endpoint is sustained glucose control without maternal hypoglycemia.", "Resistance exercise has been studied as a glucose-lowering lifestyle modality in gestational diabetes and can be considered within pregnancy-appropriate activity counseling when there is no obstetric contraindication. [8]" ], "bullets": [ "Document glucose-monitoring frequency, timing relative to meals, dietary pattern, exercise tolerance, hypoglycemic symptoms, and adherence barriers at each review.", "Escalate beyond lifestyle treatment when serial home glucose values remain above the practice's pregnancy glycemic targets despite an implementable nutrition and activity plan.", "Evaluate acute nausea, vomiting, dehydration, abdominal pain, tachypnea, or altered mentation urgently for hyperglycemic crisis; poorly controlled diabetes in pregnancy increases diabetic ketoacidosis risk. [2]" ], "subsections": [], "table": { "caption": "Pattern-based treatment review for gestational diabetes.", "columns": [ "Observed pattern", "Next clinical action", "Reason for escalation" ], "rows": [ [ "Glucose values controlled with nutrition, activity, and monitoring", "Continue the current plan and review serial logs for deterioration as gestation progresses.", "Avoid medication exposure when nonpharmacologic treatment maintains control." ], [ "Persistent fasting or postprandial hyperglycemia despite lifestyle treatment", "Offer pharmacotherapy and select insulin or an oral agent through shared decision-making. [11][20][23]", "Persistent maternal hyperglycemia is associated with adverse maternal and fetal outcomes. [2]" ], [ "Symptoms or clinical concern for acute metabolic decompensation", "Evaluate urgently for diabetic ketoacidosis and manage in a setting able to provide maternal and fetal monitoring. [2]", "Poorly controlled diabetes in pregnancy increases diabetic ketoacidosis risk. [2]" ] ] } }, { "id": "pharmacotherapy-selection", "eyebrow": "Medication", "heading": "Select insulin or oral therapy by glycemic pattern and treatment tradeoffs", "intro": "Use medication when lifestyle treatment does not achieve glucose control; align the regimen with the pattern of hyperglycemia.", "paragraphs": [ "Insulin is the reference pharmacologic treatment when gestational diabetes requires drug therapy. Insulin aspart products have pregnancy data from randomized trials in the second trimester that did not identify an association with major birth defects or adverse maternal or fetal outcomes, while poorly controlled diabetes itself carries substantial maternal-fetal risk. [2]", "Metformin is an oral alternative that may be used alone or with supplemental insulin in gestational diabetes. Randomized trial and meta-analytic comparisons have evaluated metformin versus insulin for maternal outcomes, glycemic outcomes, neonatal hypoglycemia, neonatal dextrose use, birth weight, and cesarean delivery. [23][24] The ongoing U.S. DECIDE trial is specifically evaluating whether metformin is noninferior to insulin for adverse pregnancy outcomes and will follow exposed children through 2 years postpartum, underscoring the remaining comparative-effectiveness and offspring-safety questions. [7]", "Glyburide is another oral option, but comparative analyses raise concern for higher rates of macrosomia, large-for-gestational-age birth, and neonatal hypoglycemia versus insulin. [21] If an oral agent is selected because injections are unacceptable or impractical, counsel explicitly about placental exposure considerations, likelihood of needing insulin supplementation, neonatal outcome tradeoffs, and limited long-term offspring data relative to insulin." ], "bullets": [ "Use insulin when rapid titration, reliable correction of marked hyperglycemia, or avoidance of oral drug exposure is the priority.", "Consider metformin when an oral regimen is strongly preferred and the patient accepts that supplemental insulin may be needed. [24]", "Avoid presenting glyburide as interchangeable with insulin when counseling about neonatal risk; comparative evidence identifies concern for macrosomia, large-for-gestational-age birth, and neonatal hypoglycemia. [21]", "Increase glucose-monitoring frequency when drugs that alter glycemia are added or changed; insulin labeling specifically advises increased monitoring with concomitant medications that increase hypoglycemia risk. [2]" ], "subsections": [ { "heading": "Medication safety decisions", "paragraphs": [ "Counsel patients that glycemic control is the primary modifiable risk factor. Poorly controlled diabetes in pregnancy is associated with preeclampsia, spontaneous abortion, preterm delivery, delivery complications, fetal major birth defects, stillbirth, and macrosomia-related morbidity. [2]" ], "bullets": [ "Teach injection-site rotation for insulin. Repeated injections into areas of lipodystrophy or localized cutaneous amyloidosis can alter insulin absorption; changing injection sites may require closer glucose monitoring. [2]", "If metformin is used postpartum or outside pregnancy, recognize that metformin-containing products carry a boxed warning for lactic acidosis and require discontinuation plus hospital-based supportive management if lactic acidosis is suspected. [1]" ] } ], "table": { "caption": "Medication selection considerations for gestational diabetes requiring pharmacotherapy. [2][7][21][23][24]", "columns": [ "Option", "When it may fit", "Key counseling issue" ], "rows": [ [ "Insulin", "Need for titratable therapy or preference to avoid oral glucose-lowering drugs.", "Insulin aspart pregnancy trial data from the second trimester did not identify an association with major birth defects or adverse maternal or fetal outcomes. [2]" ], [ "Metformin", "Oral treatment is preferred and the patient accepts possible addition of insulin. [24]", "Comparative effectiveness and longer-term offspring outcomes remain active areas of study. [7]" ], [ "Glyburide", "Oral option when selected after individualized counseling.", "Comparative evidence raises concern for macrosomia, large-for-gestational-age birth, and neonatal hypoglycemia compared with insulin. [21]" ] ] } }, { "id": "obstetric-and-neonatal-risk", "eyebrow": "Risk Management", "heading": "Use glycemic control to reduce maternal and neonatal complications", "intro": "Management decisions should account for both near-term perinatal risk and longer-term cardiometabolic risk.", "paragraphs": [ "Randomized evidence supports active treatment of gestational diabetes to reduce perinatal complications. [4] Communicate this purpose when discussing home monitoring, dietary change, medication escalation, and delivery planning, particularly when the patient is asymptomatic.", "Risk assessment should incorporate glycemic control and evidence of fetal overgrowth or maternal complications. Poor diabetes control is associated with macrosomia-related morbidity, stillbirth, preeclampsia, preterm delivery, and delivery complications. [2] Coordinate antepartum surveillance and timing-of-delivery planning with maternal-fetal medicine when hyperglycemia remains difficult to control or obstetric complications develop.", "For newborn planning, communicate maternal treatment and glycemic control to the pediatric team because neonatal hypoglycemia and need for neonatal dextrose have been measured outcomes in pharmacotherapy trials. [23] Comparative data also suggest that glyburide may carry less favorable neonatal risk than insulin for selected outcomes. [21]" ], "bullets": [ "Escalate to maternal-fetal medicine or endocrinology for refractory hyperglycemia, suspected pregestational diabetes, recurrent hypoglycemia during treatment, or acute metabolic decompensation.", "Ensure pediatric handoff includes diagnosis of gestational diabetes, treatment modality, degree of glycemic control, and any concern for fetal overgrowth.", "Address postpartum cardiometabolic risk before discharge rather than limiting counseling to the completed pregnancy. [9][21]" ], "subsections": [], "table": { "caption": "Complications linked to poorly controlled diabetes in pregnancy. [2]", "columns": [ "Clinical domain", "Associated complication", "Management implication" ], "rows": [ [ "Maternal metabolic", "Diabetic ketoacidosis. [2]", "Evaluate acute illness or hyperglycemic symptoms urgently." ], [ "Maternal obstetric", "Preeclampsia, spontaneous abortion, preterm delivery, and delivery complications. [2]", "Intensify glycemic and obstetric surveillance." ], [ "Fetal and neonatal", "Major birth defects, stillbirth, and macrosomia-related morbidity. [2]", "Coordinate fetal assessment, delivery planning, and neonatal handoff." ] ] } }, { "id": "postpartum-risk-reduction", "eyebrow": "Postpartum Care", "heading": "Treat gestational diabetes as a marker of future type 2 diabetes risk", "intro": "Transition from pregnancy glycemic management to durable diabetes prevention and detection.", "paragraphs": [ "A history of gestational diabetes is a major long-term risk marker: a meta-analysis cited in a comparative-treatment review found nearly a 10-fold higher risk of type 2 diabetes than after normoglycemic pregnancy. [21] Arrange postpartum glycemic testing and establish a longitudinal primary care follow-up pathway before the obstetric episode closes.", "Postpartum counseling should address weight, nutrition, physical activity, and cardiometabolic risk for both parent and child. Gestational diabetes is associated with later maternal obesity, type 2 diabetes, and cardiovascular disease, while offspring risks include obesity and type 2 diabetes. [9]", "Document gestational diabetes prominently in the problem list and discharge communication. This improves the likelihood that future clinicians recognize the need for diabetes-risk surveillance before a subsequent pregnancy and throughout adult primary care." ], "bullets": [ "Confirm completion of postpartum glucose testing and communicate the result to primary care.", "For a subsequent pregnancy, identify the prior gestational diabetes history at the first prenatal encounter and plan early glycemic risk assessment.", "Use the postpartum visit to connect the patient with sustainable nutrition, activity, weight-management, and primary care services. [9]" ], "subsections": [], "table": { "caption": "Postpartum actions after gestational diabetes. [9][21]", "columns": [ "Action", "Purpose", "Risk addressed" ], "rows": [ [ "Postpartum glycemic testing and primary care handoff", "Detect persistent dysglycemia or progression to diabetes.", "Nearly 10-fold higher type 2 diabetes risk after gestational diabetes. [21]" ], [ "Longitudinal lifestyle intervention", "Support weight, nutrition, and physical activity changes. [9]", "Maternal obesity, type 2 diabetes, and cardiovascular disease risk. [9]" ], [ "Preconception documentation for future pregnancies", "Identify prior gestational diabetes early in prenatal care.", "Recurrent pregnancy dysglycemia and diabetes-related pregnancy risk. 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A randomized control trial - ScienceDirect", "detail": "www.sciencedirect.com", "url": "https://www.sciencedirect.com/science/article/abs/pii/S0168822714004616", "authors": "www.sciencedirect.com", "host": "www.sciencedirect.com" } ], "editorialNote": "Prepared from cited clinical literature using Astra's research workflow. Verify recommendations against current guidance and patient-specific factors.", "citations": [ { "number": 1, "title": "dapagliflozin and metformin hydrochloride tablet, extended ...", "detail": "dailymed.nlm.nih.gov", "url": "https://dailymed.nlm.nih.gov/dailymed/getFile.cfm?setid=e6957674-86c1-4536-8e23-54ad7f2cacc4&type=pdf", "authors": "dailymed.nlm.nih.gov", "host": "dailymed.nlm.nih.gov", "snippet": "DAPAGLIFLOZIN AND METFORMIN HYDROCHLORIDE- dapagliflozin and metformin hydrochloride tablet, extended release Lupin Pharmaceuticals, Inc. See full prescribing information for DAPAGLIFLOZIN AND METFORMIN HYDROCHLORIDE EXTENDED-RELEASE TABLETS. DAPAGLIFLOZIN and METFORMIN HYDROCHLORIDE extended-releas", "score": 0.98052 }, { "number": 2, "title": "Garzulys - accessdata.fda.gov", "detail": "www.accessdata.fda.gov", "url": "https://www.accessdata.fda.gov/drugsatfda_docs/label/2026/761497s000lbl.pdf", "authors": "www.accessdata.fda.gov", "host": "www.accessdata.fda.gov", "snippet": "as high as 20 to 25% in women with a periconceptual HbA1c >10%. The estimated background risk of miscarriage for the indicated population is unknown. Clinical Considerations Drugs That May Increase the Risk of Hypoglycemia Reference ID: 5840873 Page 10 of 20 Disease-Associated Maternal and/or Embryo", "score": 0.40302688 }, { "number": 3, "title": "Treatment of Gestational Diabetes Mellitus Diagnosed ...", "detail": "www.nejm.org", "url": "https://www.nejm.org/doi/full/10.1056/NEJMoa2214956", "authors": "www.nejm.org", "host": "www.nejm.org", "snippet": "by D Simmons · 2023 · Cited by 464 — Whether treatment of gestational diabetes before 20 weeks' gestation improves maternal and infant health is unclear.", "score": 0.2609451 }, { "number": 4, "title": "Effect of Treatment of Gestational Diabetes Mellitus on ...", "detail": "www.nejm.org", "url": "https://www.nejm.org/doi/full/10.1056/NEJMoa042973", "authors": "www.nejm.org", "host": "www.nejm.org", "snippet": "by CA Crowther · 2005 · Cited by 4542 — We conducted a randomized clinical trial to determine whether treatment of women with gestational diabetes mellitus reduced the risk of perinatal", "score": 0.22134264 }, { "number": 5, "title": "Screening for Gestational Diabetes: US Preventive ...", "detail": "jamanetwork.com", "url": "https://jamanetwork.com/journals/jama/fullarticle/2782858", "authors": "jamanetwork.com", "host": "jamanetwork.com", "snippet": "by US Preventive Services Task Force · 2021 · Cited by 174 — During the OGTT, a fasting glucose level is obtained, followed by administration of a 75-g or 100-g glucose load, then evaluation of glucose", "score": 0.6745014 }, { "number": 6, "title": "USPSTF Review: Screening for Gestational Diabetes", "detail": "jamanetwork.com", "url": "https://jamanetwork.com/journals/jama/fullarticle/2782859", "authors": "jamanetwork.com", "host": "jamanetwork.com", "snippet": "by J Pillay · 2021 · Cited by 115 — Prediction of gestational diabetes mellitus and pre-diabetes 5 years postpartum using 75-g oral glucose tolerance test at 14-16 weeks' gestation", "score": 0.60861784 }, { "number": 7, "title": "Comparative effectiveness trial of metformin versus insulin for the treatment of gestational diabetes in the USA: clinical trial protocol for the multicentre DECIDE study | BMJ Open", "detail": "bmjopen.bmj.com", "url": "https://bmjopen.bmj.com/content/14/9/e091176", "authors": "bmjopen.bmj.com", "host": "bmjopen.bmj.com", "snippet": "In addition, the patient-reported experiences of individuals with GDM requiring pharmacotherapy remain to be characterised, including barriers to and facilitators of metformin versus insulin use. **Methods and analysis** In a two-arm open-label, pragmatic comparative effectiveness randomised control", "score": 0.98558 }, { "number": 8, "title": "Effects of resistance exercise on blood glucose level and ...", "detail": "drc.bmj.com", "url": "https://drc.bmj.com/content/10/2/e002622", "authors": "drc.bmj.com", "host": "drc.bmj.com", "snippet": "by Y Xie · 2022 · Cited by 79 — GDM can increase the risk of adverse outcomes and type 2 diabetes mellitus (DM) in pregnant women and their offspring. maternal and neonatal", "score": 0.97958 }, { "number": 9, "title": "Improving cardiometabolic and mental health in women with gestational diabetes mellitus and their offspring: study protocol for MySweetHeart Trial, a randomised controlled trial | BMJ Open", "detail": "bmjopen.bmj.com", "url": "https://bmjopen.bmj.com/content/8/2/e020462", "authors": "bmjopen.bmj.com", "host": "bmjopen.bmj.com", "snippet": "**Introduction** Gestational diabetes mellitus (GDM) carries prenatal and perinatal risk for the mother and her offspring as well as longer-term risks for both the mother (obesity, diabetes, cardiovascular disease) and her child (obesity, type 2 diabetes). Lifestyle interventions for GDM are general", "score": 0.96845 }, { "number": 10, "title": "Screening and nursing management of gestational ...", "detail": "www.cell.com", "url": "https://www.cell.com/heliyon/fulltext/S2405-8440(23)02558-6", "authors": "www.cell.com", "host": "www.cell.com", "snippet": "by GP Mensah · 2023 · Cited by 2 — To describe the development of evidence-based recommendations for screening and nursing management of gestational diabetes mellitus (GDM) in Ghana", "score": 0.29721537 }, { "number": 11, "title": "Metformin in gestational diabetes: physiological actions and clinical applications | Nature Reviews Endocrinology", "detail": "www.nature.com", "url": "https://www.nature.com/articles/s41574-024-01049-w", "authors": "www.nature.com", "host": "www.nature.com", "snippet": "Article \n CAS \n PubMed \n Google Scholar\n156. Guo, L. et al. Comparative efficacy and safety of metformin, glyburide, and insulin in treating gestational diabetes mellitus: a meta-analysis. J. Diabetes Res. 2019, 9804708 (2019).\n\n Article \n PubMed \n PubMed Central \n Google", "score": 0.7653308 }, { "number": 12, "title": "Initiative on gestational diabetes mellitus", "detail": "obgyn.onlinelibrary.wiley.com", "url": "https://obgyn.onlinelibrary.wiley.com/doi/pdf/10.1016%2FS0020-7292%2815%2930033-3", "authors": "obgyn.onlinelibrary.wiley.com", "host": "obgyn.onlinelibrary.wiley.com", "snippet": "by M Hod · 2015 · Cited by 1573 — Guidelines and recommendations for laboratory analysis in the diagnosis and management of diabetes mellitus.", "score": 0.40641484 }, { "number": 13, "title": "Evaluation of Clinical Practice Guidelines on Timing and ...", "detail": "obgyn.onlinelibrary.wiley.com", "url": "https://obgyn.onlinelibrary.wiley.com/doi/10.1111/1471-0528.70191", "authors": "obgyn.onlinelibrary.wiley.com", "host": "obgyn.onlinelibrary.wiley.com", "snippet": "Gestational diabetes mellitus (GDM) is the most common pregnancy complication globally, yet recommendations for the timing and onset of labour", "score": 0.4051433 }, { "number": 14, "title": "Australasian Diabetes in Pregnancy Society (ADIPS) 2025 ...", "detail": "onlinelibrary.wiley.com", "url": "https://onlinelibrary.wiley.com/doi/10.5694/mja2.52696", "authors": "onlinelibrary.wiley.com", "host": "onlinelibrary.wiley.com", "snippet": "In 2014, ADIPS recommended gestational diabetes mellitus be diagnosed any time during pregnancy based on HAPO OR 1.75 one-step POGTT glucose", "score": 0.28114697 }, { "number": 15, "title": "Society for Maternal‐Fetal Medicine Special Statement ...", "detail": "obgyn.onlinelibrary.wiley.com", "url": "https://obgyn.onlinelibrary.wiley.com/doi/10.1002/pmf2.70264", "authors": "obgyn.onlinelibrary.wiley.com", "host": "obgyn.onlinelibrary.wiley.com", "snippet": "In 2020, the Society for Maternal-Fetal Medicine published an updated checklist for antepartum care of pregestational diabetes mellitus.", "score": 0.27753463 }, { "number": 16, "title": "Infant Transfer of Medications for Type 2 Diabetes Mellitus Via ...", "detail": "ascpt.onlinelibrary.wiley.com", "url": "https://ascpt.onlinelibrary.wiley.com/doi/pdf/10.1002/cpt.70211", "authors": "ascpt.onlinelibrary.wiley.com", "host": "ascpt.onlinelibrary.wiley.com", "snippet": "by K Richardson · 2026 · Cited by 1 — Prominent guidelines like the National Institute for Health and Care Excellence (NICE), American Diabetes Association. (ADA), and the Royal Australian College", "score": 0.2768816 }, { "number": 17, "title": "Gestational diabetes mellitus screening and diagnosis: a ...", "detail": "obgyn.onlinelibrary.wiley.com", "url": "https://obgyn.onlinelibrary.wiley.com/doi/10.1111/j.1471-0528.2009.02475.x", "authors": "obgyn.onlinelibrary.wiley.com", "host": "obgyn.onlinelibrary.wiley.com", "snippet": "The direct sampling costs of the glucose tests per woman were as follows: 75-g OGTT, $36.10; 100-g OGTT, CAN$48.13. 75-g OGTT and CAN$48.13 for", "score": 0.7161595 }, { "number": 18, "title": "Medicine®", "detail": "journals.lww.com", "url": "https://journals.lww.com/md-journal/_layouts/15/oaks.journals/downloadpdf.aspx?an=00005792-202203110-00029", "authors": "journals.lww.com", "host": "journals.lww.com", "snippet": "by HH Cha · 2022 · Cited by 2 — The implementation cutoffs for gestational diabetes mellitus (GDM) confirmation and exclusion at 50-g oral glucose tolerance test (OGTT), 0- and. 1-h of 100-g", "score": 0.51032627 }, { "number": 19, "title": "Diabetes Mellitus in Pregnancy", "detail": "journals.lww.com", "url": "https://journals.lww.com/anesthesiology/_layouts/15/oaks.journals/downloadpdf.aspx?an=00000542-202508000-00028", "authors": "journals.lww.com", "host": "journals.lww.com", "snippet": "by WK Rogers · 2025 · Cited by 5 — They discuss the indications and limitations of technologies such as continuous glucose monitors and insulin pumps in pregnancy, and describe their relevance", "score": 0.9859 }, { "number": 20, "title": "Comparative efficacy and safety of oral antidiabetic drugs... : Medicine", "detail": "journals.lww.com", "url": "https://journals.lww.com/md-journal/fulltext/2017/09220/comparative_efficacy_and_safety_of_oral.12.aspx", "authors": "journals.lww.com", "host": "journals.lww.com", "snippet": "Title: Comparative efficacy and safety of oral antidiabetic drugs... : Medicine\nAbbreviations: 2HPG = 2-hour postprandial glucose, FBG = fasting blood glucose, GDM = gestational diabetes mellitus, LGA = large for gestational age, NAM = network meta-analysis, NICU = neonatal intensive care unit, OADs", "score": 0.8674071 }, { "number": 21, "title": "Comparative efficacy and safety of glyburide, metformin,... : Medicine", "detail": "journals.lww.com", "url": "https://journals.lww.com/md-journal/fulltext/2022/03180/comparative_efficacy_and_safety_of_glyburide,.43.aspx", "authors": "journals.lww.com", "host": "journals.lww.com", "snippet": "_How to cite this article: Lin J, Tu Rz, Hong Xy. Comparative efficacy and safety of glyburide, metformin, and insulin in treatment of gestational diabetes mellitus: a protocol for systematic review and meta-analysis. We aimed to assess the comparative efficiency and safety of the use of glyburide, ", "score": 0.86024034 }, { "number": 22, "title": "Gestational diabetes mellitus management with oral hypoglycemic agents - ScienceDirect", "detail": "www.sciencedirect.com", "url": "https://www.sciencedirect.com/science/article/abs/pii/S0146000514001001", "authors": "www.sciencedirect.com", "host": "www.sciencedirect.com", "snippet": "# Gestational diabetes mellitus management with oral hypoglycemic agents. Oral hypoglycemic agents such as glyburide (second-generation sulfonylurea) and metformin (biguanide) are attractive alternatives to insulin due to lower cost, ease of administration, and better patient adherence. The majority", "score": 0.846159 }, { "number": 23, "title": "Comparative Efficacy and Safety of Metformin, Glyburide, and Insulin in Treating Gestational Diabetes Mellitus: A Meta‐Analysis - Guo - 2019 - Journal of Diabetes Research - Wiley Online Library", "detail": "onlinelibrary.wiley.com", "url": "https://onlinelibrary.wiley.com/doi/10.1155/2019/9804708", "authors": "onlinelibrary.wiley.com", "host": "onlinelibrary.wiley.com", "snippet": "To compare the efficacy and safety of metformin, glyburide, and insulin in treating gestational diabetes mellitus (GDM), a meta-analysis of randomized controlled trials (RCTs) was conducted. Studies were included if they met the following criteria: subjects were women with gestational diabetes requi", "score": 0.83290404 }, { "number": 24, "title": "Metformin versus insulin treatment in gestational diabetes in pregnancy in a developing country. A randomized control trial - ScienceDirect", "detail": "www.sciencedirect.com", "url": "https://www.sciencedirect.com/science/article/abs/pii/S0168822714004616", "authors": "www.sciencedirect.com", "host": "www.sciencedirect.com", "snippet": "# Metformin versus insulin treatment in gestational diabetes in pregnancy in a developing country. ### Aim. To compare treatment with metformin alone, metformin plus insulin and insulin alone in women with gestational diabetes (GDM). Metformin is an effective and cheap treatment option for women wit", "score": 0.82425016 } ], "publishedAt": "2026-08-21T01:57:12.185228+00:00", "updatedAt": "2026-08-21T01:57:12.185228+00:00", "readingMinutes": 6, "slug": "gestational-diabetes" }