Oral antidiabetic for the metabolic control in gestational diabetes

Authors

  • Yoany Marín Tápanes Hospital Ginecoobstétrico “Mariana Grajales”, Santa Clara, Villa Clara, Cuba
  • Sandi Jiménez Puñales Hospital Ginecoobstétrico “Mariana Grajales”, Santa Clara, Villa Clara, Cuba

Keywords:

diabetes gestacional, hipoglicemiantes orales, control metabólico

Abstract

The search for alternative therapies to insulin for the treatment of gestational diabetes goes back to studies from the decade of 1970 and 1980. The oral hypoglycemic agents have emerged as an effective alternative for metabolic control of gestational diabetes; these drugs have historically been rejected by the medical community on the basis of studies with serious methodological flaws. Metformin is a useful and safe alternative for its control, to reduce costs and improve the margin of safety that involves the use of insulin. There is sufficient information that supports that glyburide is safe during pregnancy. Many of the fears for the use of oral hypoglycemic agents have been clarified today. Up to now it has not been reported in pregnant the use of other oral hypoglycemic agents and, therefore, they must not be used.

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Author Biographies

Yoany Marín Tápanes, Hospital Ginecoobstétrico “Mariana Grajales”, Santa Clara, Villa Clara, Cuba

Especialista de I Grado en Ginecología y Obstetricia. Máster en Atención Integral a la Mujer. Profesora Auxiliar de la Universidad de Ciencias Médicas de Villa Clara “Dr. Serafín Ruiz de Zárate Ruiz”.

Sandi Jiménez Puñales, Hospital Ginecoobstétrico “Mariana Grajales”, Santa Clara, Villa Clara, Cuba

Especialista de I Grado en Medicina General Integral. Especialista de I y II Grado en Ginecología y Obstetricia. Máster en Atención Integral a la Mujer. Profesor Auxiliar de la Universidad de Ciencias Médicas de Villa Clara “Dr. Serafín Ruiz de Zárate Ruiz”.

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Published

2016-10-03

How to Cite

1.
Marín Tápanes Y, Jiménez Puñales S. Oral antidiabetic for the metabolic control in gestational diabetes. Acta Méd Centro [Internet]. 2016 Oct. 3 [cited 2025 Jul. 3];10(4):81-90. Available from: https://revactamedicacentro.sld.cu/index.php/amc/article/view/769

Issue

Section

Review Articles