Gestational diabetes medication risk is high! The longer the duration, the greater the risk of offspring
Gestational diabetes (GDM) is one of the common complications during pregnancy, and the incidence has been on the rise in recent years. Several recent studies have shown that drug treatment for gestational diabetes may have a long-term impact on the neurodevelopment of offspring, especially the longer the drug treatment lasts, the higher the risk of neurodevelopment of offspring. This article will combine the hot research data of the entire network for nearly 10 days to analyze this topic in detail.
1. Current status of drug treatment for gestational diabetes
Treatment of gestational diabetes usually involves dietary control, exercise and medication. When lifestyle interventions are not effective, your doctor may recommend using insulin or oral hypoglycemic drugs. Here are the statistics on the use of GDM drug treatments in the past 10 days:
| Drug Type | Use ratio | Average treatment cycle |
|---|---|---|
| insulin | 62.3% | 18.5 weeks |
| Glibenurea | 25.7% | 12.3 weeks |
| Metformin | 12.0% | 14.8 weeks |
2. Research on the association between drug treatment and neurodevelopment risk in offspring
The latest cohort study published in JAMA Pediatrics shows that the duration of gestational diabetes medication is positively correlated with the risk of neurodevelopmental disorders in offspring. The study followed 12,450 children born between 2010 and 2020 and found:
| Duration of treatment | Autism spectrum disorder risk | Risk of attention deficit hyperactivity disorder | Learning disability risk |
|---|---|---|---|
| <8 weeks | 1.12 times | 1.08 times | 1.05 times |
| 8-16 weeks | 1.34 times | 1.27 times | 1.18 times |
| >16 weeks | 1.67 times | 1.52 times | 1.43 times |
3. The risk differences between different drugs
The study also compared the effects of different drugs on the neurodevelopment of offspring. The results showed that the risk in the insulin-treated group was relatively low, while the risk of oral hypoglycemia was higher:
| Drug Type | Comprehensive risk ratio of neurodevelopmental disorders | 95% confidence interval |
|---|---|---|
| insulin | 1.21 | 1.09-1.34 |
| Glibenurea | 1.45 | 1.28-1.64 |
| Metformin | 1.32 | 1.15-1.52 |
4. Expert advice and clinical guidance
In view of this research results, domestic and foreign experts have put forward the following suggestions:
1.Strictly grasp the indications of drug treatment: Drug intervention is only considered when diet and exercise control is ineffective (fasting blood sugar > 5.3 mmol/L or blood sugar > 6.7 mmol/L 2 hours after meals).
2.Preferential insulin therapy: Insulin should be the first choice when medication is required, especially long-acting insulin analogs.
3.Control treatment time: Shorten the drug treatment time as much as possible and gradually reduce the amount after blood sugar control meets the standards.
4.Strengthen fetal monitoring: For pregnant women receiving drug treatment, ultrasound examination of fetal nervous system development should be increased.
5.Postpartum follow-up: Long-term neurodevelopmental assessment is recommended for neonates exposed to GDM drug treatment.
5. Future research direction
The researchers point out that more research is needed to clarify:
- Specific mechanisms by which drugs affect fetal brain development through placenta
- Different safety differences in different insulin preparations
- Optimal treatment time window and dose threshold
- Possible protective interventions
At present, the American Diabetes Association (ADA) has stated that it will reevaluate GDM drug treatment guidelines and is expected to release an updated version in 2024.
Conclusion
Although gestational diabetes drug treatment can effectively control blood sugar, it may have a long-term impact on the neurodevelopment of the offspring. This latest study reminds clinicians and patients to weigh the pros and cons, and while ensuring the safety of mother and child, control blood sugar as much as possible through lifestyle interventions to reduce unnecessary drug exposure. For cases where medications are required, drugs with lower risks should be selected and treatment time should be strictly controlled.
en
