Spontaneous singleton and twin pregnancy in two patients with polycystic ovary syndrome and type 2 diabetes following treatment with metformin combined with rosiglitazone

Demissie, Yared N; Fiad, T. M.; Klemm, Katja; Twfeeg, Afaf; Alamoudi, Abdullah; Meer, Lorna; Elhadd, Tarik

doi:10.5144/0256-4947.2006.296

Cited by 6 publications

(2 citation statements)

References 32 publications

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“…Although thiazolinediones do not appear to be teratogenic, they readily cross the placenta and their use has been associated with fetal death and growth retardation, secondary to placental dysfunction. There are only limited data in human pregnancy and so the use of thiazolinediones is not recommended.…”

Section: Thiazolidinedionesmentioning

confidence: 99%

The use of oral hypoglycaemic agents in pregnancy

Holt

Lambert

2014

Diabet. Med.

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While insulin has been the treatment of choice when lifestyle measures do not maintain glycaemic control during pregnancy, recent studies have suggested that certain oral hypoglycaemic agents may be safe and acceptable alternatives. With the exception of metformin and glibenclamide (glyburide), there are insufficient data to recommend treatment with any other oral hypoglycaemic agent during pregnancy. There are no serious safety concerns with metformin, despite it crossing the placenta. When used in the first trimester, there is no increase in congenital abnormalities and there appears to be a reduction in miscarriage, pre-eclampsia and subsequent gestational diabetes. Studies of the use of metformin in gestational diabetes show at least equivalent neonatal outcomes, while reporting reductions in neonatal hypoglycaemia, maternal hypoglycaemia and weight gain and improved treatment satisfaction. Glibenclamide effectively lowers blood glucose in women with gestational diabetes, possibly with a lower treatment failure rate than metformin. Although generally well tolerated, some studies have reported higher rates of pre-eclampsia, neonatal jaundice, longer stay in the neonatal care unit, macrosomia and neonatal hypoglycaemia. There is a paucity of long-term follow-up data on children exposed to oral agents in utero. The American College of Obstetrics and Gynecology and the UK National Institute of Health and Care Excellence (NICE) have recommended that either metformin or glibenclamide can be used to treat gestational diabetes. Metformin is also recommended for use in the pre-conception period by NICE. By contrast, the American Diabetes Association recommends that both drugs should only be used during pregnancy in the context of clinical trials.

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Section: Thiazolidinedionesmentioning

confidence: 99%

The use of oral hypoglycaemic agents in pregnancy

Holt

Lambert

2014

Diabet. Med.

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“…Owing to their relatively novel use, data on patient exposure have been limited case reports [59,60]. In one such instance, inadvertent use of rosiglitazone was discontinued at 8 weeks once pregnancy was suspected [59].…”

Section: Thiazolidinedionesmentioning

confidence: 96%

Diabetic Medications in Pregnancy

Young¹,

Anwar²

2009

CDR

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All forms of diabetes are increasing in prevalence, but with the advent of the obesity epidemic, we now face the prospect of an increasing number of women conceiving whilst taking traditional oral antidiabetic agents (OADs). This is also further complicated by the availability of new incretin-based therapies, the dipeptidylpeptidase-4 (DPP-IV) inhibitors and glucagon-like-1 receptor (GLP-1R) analogues. Original concerns regarding the use of such OADs have meant that diet control and insulin has been the mainstay of treatment for hyperglycaemia during pregnancy. However, recent NICE guidelines have suggested a role for oral antidiabetic agents. Safety is of paramount concern, especially in pregnancy, and this review will discuss the evidence to date.

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Medical Treatment

Baillargeon¹,

Farid²

2009

Diagnosis and Management of Polycystic Ovary Syndrome

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Spontaneous singleton and twin pregnancy in two patients with polycystic ovary syndrome and type 2 diabetes following treatment with metformin combined with rosiglitazone

Cited by 6 publications

References 32 publications

The use of oral hypoglycaemic agents in pregnancy

The use of oral hypoglycaemic agents in pregnancy

Diabetic Medications in Pregnancy

Medical Treatment

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