Oral Medication for Gestational Diabetes

Treatment for gestational diabetes aims to keep blood glucose levels equivalent to those of pregnant women without gestational diabetes. Although insulin is still the treatment of choice for women with gestational diabetes mellitus, it has some disadvantages, including that it is administered as an injection and it causes weight gain. Besides, it does not address the basic problem with these women that is insulin resistance, this is a condition in which the cells of the body become resistant to the effect of insulin and this resistance is a risk factor for development of diabetes.

Metformin is one of the oral medications for the treatment of gestational diabetes. As expert studies have shown, this is an option for effective and safe treatment during pregnancy, with the advantage over insulin that women may have better adherence, it improves insulin sensitivity and is not associated with weight gain or low blood glucose.

Metformin acts by increasing insulin sensitivity in the liver and thus decreases the release of glucose and the production of glucose by the liver. Metformin also increases insulin sensitivity in muscle, thus improving glucose utilization during activity. It can also have unknown effects such as decreased appetite and decrease in glucose absorption in the intestine. The main side effects that can occur with Metformin are diarrhea and intestinal or abdominal discomfort in up to 20-30% of people who use it, also can produce fever or chills, general feeling of discomfort, sleepiness, painful urination, lower back pain and muscle pain or cramping.

Less common effects are anxiety, confusion, cold sweats, chest discomfort, increased hunger, headache, dizziness, nausea, shortness of breath, tightness in the chest, nightmares, and shakiness. Most of the adverse effects of Metformin usually do not need medical attention, because they usually go away as your body adjusts to the medication. Your doctor can tell you how to prevent or reduce some of these annoying effects. If the effects persist you may have to interrupt the use of Metformin and start insulin.

The doses of Metformin that are recommended during pregnancy vary from 1000mg to 2500mg per day. So far has not been found difference in the rate of complications for the mother and baby before and after the delivery period when compared with the insulin, and has a better acceptance by pregnant women. For the benefits that can produce Metformin its use is recommended as a treatment for gestational diabetes mellitus with insulin or as an alternative treatment, being more useful in cases where the pregnant rejects the use of insulin for cultural or economic reasons.
By Orfa Reyes

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