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Med."],"published-print":{"date-parts":[[2014,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>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\u2010eclampsia 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\u2010eclampsia, neonatal jaundice, longer stay in the neonatal care unit, macrosomia and neonatal hypoglycaemia. There is a paucity of long\u2010term follow\u2010up data on children exposed to oral agents <jats:italic>in utero<\/jats:italic>. The American College of Obstetrics and Gynecology and the <jats:styled-content style=\"fixed-case\">UK<\/jats:styled-content> National Institute of Health and Care Excellence (<jats:styled-content style=\"fixed-case\">NICE<\/jats:styled-content>) have recommended that either metformin or glibenclamide can be used to treat gestational diabetes. Metformin is also recommended for use in the pre\u2010conception period by <jats:styled-content style=\"fixed-case\">NICE<\/jats:styled-content>. By contrast, the American Diabetes Association recommends that both drugs should only be used during pregnancy in the context of clinical trials.<\/jats:p>","DOI":"10.1111\/dme.12376","type":"journal-article","created":{"date-parts":[[2013,12,4]],"date-time":"2013-12-04T11:36:41Z","timestamp":1386157001000},"page":"282-291","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":36,"title":["The use of oral hypoglycaemic agents in pregnancy"],"prefix":"10.1111","volume":"31","author":[{"given":"R. I. G.","family":"Holt","sequence":"first","affiliation":[{"name":"Human Development and Health Academic Unit Faculty of Medicine University of Southampton Southampton UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"K. 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