{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T16:38:43Z","timestamp":1793119123037,"version":"4.5.0"},"reference-count":42,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2021,11,8]],"date-time":"2021-11-08T00:00:00Z","timestamp":1636329600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2022,2]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To define patterns of prescription and factors associated with choice of pharmacotherapy for gestational diabetes mellitus (GDM), namely metformin, glyburide and insulin, during a period of evolving professional guidelines.<\/jats:p><\/jats:sec><jats:sec><jats:title>Desing<\/jats:title><jats:p>Cross\u2010sectional study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>US commercial insurance beneficiaries from Market\u2010Scan (late 2015 to 2018).<\/jats:p><\/jats:sec><jats:sec><jats:title>Study design<\/jats:title><jats:p>We included women with GDM, singleton gestations, 15\u201351\u00a0years of age on pharmacotherapy. The exposure was pharmacy claims for metformin, glyburide and insulin.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcomes<\/jats:title><jats:p>Pharmacotherapy for GDM with either oral agent, metformin or glyburide, compared with insulin as the reference, and secondarily, consequent treatment modification (addition and\/or change) to metformin, glyburide or insulin.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 37\u00a0762 women with GDM, we analysed data from 10\u00a0407 (28%) with pharmacotherapy, 21% with metformin (<jats:italic>n<\/jats:italic>\u00a0=\u00a02147), 48% with glyburide (<jats:italic>n<\/jats:italic>\u00a0=\u00a04984) and 31% with insulin (<jats:italic>n<\/jats:italic>\u00a0=\u00a03276). From late 2015 to 2018, metformin use increased from 17 to 29%, as did insulin use from 26 to 44%, whereas glyburide use decreased from 58 to 27%. By 2018, insulin was the most common pharmacotherapy for GDM; metformin was more likely to be prescribed by 9% compared with late 2015\/16, but glyburide was less likely by 45%. Treatment modification occurred in 20% of women prescribed metformin compared with 2% with insulin and 8% with glyburide.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Insulin followed by metformin has replaced glyburide as the most common pharmacotherapy for GDM among a privately insured US population during a time of evolving professional guidelines. Further evaluation of the relative effectiveness and safety of metformin compared with insulin is needed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Tweetable abstract<\/jats:title><jats:p>Insulin followed by metformin has replaced glyburide as the most common pharmacotherapy for gestational diabetes mellitus in the USA.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1471-0528.16960","type":"journal-article","created":{"date-parts":[[2021,10,5]],"date-time":"2021-10-05T03:21:58Z","timestamp":1633404118000},"page":"473-483","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Changing patterns in medication prescription for gestational diabetes during a time of guideline change in the USA: a cross\u2010sectional study"],"prefix":"10.1111","volume":"129","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8043-556X","authenticated-orcid":false,"given":"KK","family":"Venkatesh","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology The Ohio State University Columbus OH USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"CW","family":"Chiang","sequence":"additional","affiliation":[{"name":"Department of Bioinformatics The Ohio State University Columbus OH USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"WC","family":"Castillo","sequence":"additional","affiliation":[{"name":"Department of Pharmaceutical Health Services Research University of Maryland Baltimore Baltimore MD USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"AN","family":"Battarbee","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology University of Alabama Birmingham AB USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M","family":"Donneyong","sequence":"additional","affiliation":[{"name":"College of Pharmacy The Ohio State University Columbus OH USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"LM","family":"Harper","sequence":"additional","affiliation":[{"name":"Department of Women\u2019s Health University of Texas Dell Medical School Austin TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M","family":"Costantine","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology The Ohio State University Columbus OH USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G","family":"Saade","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology University of Texas Medical Branch Galveston TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"EF","family":"Werner","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Alpert Medical School of Brown University Providence RI USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"KA","family":"Boggess","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology University of North Carolina Chapel Hill NC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"MB","family":"Landon","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology The Ohio State University Columbus OH USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,11,8]]},"reference":[{"key":"e_1_2_7_2_1","volume-title":"Gestational Diabetes. 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