Gestational diabetes mellitus management with oral hypoglycemic agents

Semin Perinatol. 2014 Dec;38(8):508-15. doi: 10.1053/j.semperi.2014.08.012. Epub 2014 Oct 12.


Oral hypoglycemic agents such as glyburide (second-generation sulfonylurea) and metformin (biguanide) are attractive alternatives to insulin due to lower cost, ease of administration, and better patient adherence. The majority of evidence from retrospective and prospective studies suggests comparable efficacy and safety of oral hypoglycemic agents such as glyburide and metformin as compared to insulin when used in the treatment of women with gestational diabetes mellitus (GDM). Glyburide and metformin have altered pharmacokinetics during pregnancy and both agents cross the placenta. In this article, we review the efficacy, safety, and dosage of oral hypoglycemic agents for the treatment of gestational diabetes mellitus. Additional research is needed to evaluate optimal dosage for glyburide and metformin during pregnancy. Comparative studies evaluating the effects of glyburide and metformin on long-term maternal and fetal outcomes are also needed.

Keywords: Gestational diabetes; Glyburide; Hypoglycemic agents; Metformin; Pregnancy outcome.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Administration, Oral
  • Diabetes, Gestational / drug therapy*
  • Female
  • Glyburide / administration & dosage*
  • Humans
  • Hypoglycemic Agents / administration & dosage*
  • Hypoglycemic Agents / therapeutic use
  • Insulin / therapeutic use
  • Metformin / administration & dosage*
  • Pregnancy
  • Pregnancy Outcome


  • Hypoglycemic Agents
  • Insulin
  • Metformin
  • Glyburide