Use of antidiabetes agents in pregnancy: current practice and controversy

Prior to the discovery of insulin, the combination of diabetes and pregnancy was considered potentially lethal. Advances in the care of diabetes, combined with advances in antepartum fetal testing, have reduced maternal and perinatal mortality outcomes to levels expected in nondiabetic pregnancies. As new oral antidiabetes medications are introduced, the safety and efficacy of using them during pregnancy are under investigation. This article describes the oral medications currently available to treat diabetes, reviews the body of research available on these agents, and discusses current recommendations and controversies.