Insulin remains the standard treatment for gestational diabetes when dietary interventions fail, offering improved perinatal outcomes. Oral medications such as metformin and glyburide have recently gained attention as cost-effective and patient-friendly alternatives. However, concerns remain about their placental transfer and long-term safety. To address this, a study has investigated whether sequential treatment with metformin and glyburide is more effective than insulin in preventing large-for-gestational-age infants among 820 gestational diabetes patients.
The study revealed that 79% of patients treated with oral agents maintained glycemic control without insulin. However, using oral agents was associated with a higher incidence of infants born large for gestational age than insulin treatment (23.9% vs. 19.9%). Additionally, oral glucose-lowering agents were linked to higher rates of…
