ABSTRACT
The use of oral hypoglycemic agents in nonpregnant patients with type 2 diabetes has become the standard of care in the United States. The randomized study of the use of oral hypoglycemic agents demonstrated that glyburide is an efficacious alternative to insulin in the treatment of diabetes in the pregnant subject. The oral hypoglycemic agents act, depending upon the specific group, directly upon the beta cells to increase insulin secretion and/or to decrease hepatic glucose production and increase peripheral insulin sensitivity. The intensified insulin approach in the management of Gestational diabetes mellitus has been shown to result in perinatal outcomes comparable to those in the general population; thus, it has become the method of choice for the control of glycemia. The incidence of congenital anomalies in nondiabetic women is 2%–3%: the rate increases to 7%–9% overall in pregnant diabetic patients and is even higher in poorly controlled diabetics and as the severity of the disease increases.
