Metformin in the treatment of hyperglycemia during pregnancy and periconception: guideline-informed expert recommendations from seven countries/states in the Asia-Pacific region.

IF 2.2 4区 医学 Q1 MEDICINE, GENERAL & INTERNAL
Current Medical Research and Opinion Pub Date : 2025-07-01 Epub Date: 2025-08-01 DOI:10.1080/03007995.2025.2496430
Nemencio Nicodemus, Virgilio Novero, Wiryawan Permadi, Ketut Suastika, Alexander Tan Tong Boon, Chaicharn Deerochanawong, Kerstin Brand, Maria Christina Hanindita, Alina Markova
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Abstract

Hyperglycemia in pregnancy (HIP) poses significant risks to maternal and fetal health yet remains underreported, particularly in the Asia-Pacific region. This public health challenge includes gestational diabetes mellitus, pre-existing diabetes, and diabetes diagnosed during pregnancy, with regional prevalence rates as high as 28%. Left untreated, HIP can lead to adverse maternal outcomes such as preeclampsia and excessive gestational weight gain, as well as neonatal complications, including macrosomia and neonatal hypoglycemia. International and regional guidelines emphasize early detection and tailored interventions when addressing unmet medical needs in HIP management. Screening protocols vary, with a one-step oral glucose tolerance test increasingly favored for its diagnostic accuracy. Metformin, recognized for its favorable safety profile, efficacy, and cost-effectiveness, has emerged as a preferred first-line treatment alongside lifestyle modifications. Recent updates to metformin's regulatory labeling highlight its safe use during pregnancy, with evidence demonstrating benefits such as reduced maternal weight gain and neonatal complications. This expert recommendation from the Asia-Pacific region focus on the use of metformin during pregnancy and the periconceptional period. Recommendations advocate for routine screening, optimal glycemic control, and structured postpartum care to mitigate HIP's long-term health impacts. Integrating metformin into management strategies enhances patient satisfaction, accessibility, and overall outcomes, offering a practical solution to improve maternal and neonatal health in diverse healthcare settings.

二甲双胍治疗妊娠期和围孕期高血糖:来自亚太地区7个国家/州的专家建议
妊娠期高血糖(HIP)对孕产妇和胎儿健康构成重大风险,但仍未得到充分报道,特别是在亚太地区。这一公共卫生挑战包括妊娠期糖尿病(GDM)、既往糖尿病和妊娠期诊断的糖尿病,区域患病率高达28%。如果不及时治疗,HIP可导致不良的产妇结局,如先兆子痫和妊娠期体重过度增加,以及新生儿并发症,包括巨大儿和新生儿低血糖。国际和区域准则强调在解决HIP管理中未满足的医疗需求时早期发现和有针对性的干预措施。筛查方案各不相同,一步口服葡萄糖耐量试验(OGTT)因其诊断准确性越来越受到青睐。二甲双胍以其良好的安全性、有效性和成本效益而闻名,已成为改变生活方式的首选一线治疗方法。最近对二甲双胍监管标签的更新强调了其在妊娠期间的安全使用,并有证据表明其益处,如减少产妇体重增加和新生儿并发症。这项来自亚太地区的专家建议侧重于在怀孕和围孕期使用二甲双胍。建议提倡常规筛查、最佳血糖控制和有组织的产后护理,以减轻HIP的长期健康影响。将二甲双胍纳入管理策略可提高患者满意度、可及性和总体结果,为改善不同医疗保健环境中的孕产妇和新生儿健康提供实用的解决方案。
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来源期刊
Current Medical Research and Opinion
Current Medical Research and Opinion 医学-医学:内科
CiteScore
4.40
自引率
4.30%
发文量
247
审稿时长
3-8 weeks
期刊介绍: Current Medical Research and Opinion is a MEDLINE-indexed, peer-reviewed, international journal for the rapid publication of original research on new and existing drugs and therapies, Phase II-IV studies, and post-marketing investigations. Equivalence, safety and efficacy/effectiveness studies are especially encouraged. Preclinical, Phase I, pharmacoeconomic, outcomes and quality of life studies may also be considered if there is clear clinical relevance
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