CARACTERÍSTICA FARMACOLÓGICA DA METFORMINA NO TRATAMENTO DA DIABETES GESTACIONAL

Abstract

The present study aims to analyze a scientific production on the pharmacological aspects of metformin and its risks/benefits in the treatment of Gestational Diabetes Mellitus (GDM) compared to insulin therapy. For this, a search and selection of scientific articles was carried out on the Scielo, Pubmed and Lilacs platforms; using the descriptors: gestational diabetes, pharmacology, pharmacological treatment, metformin, insulin and insulin therapy. Inclusion was based on the following criteria: full free access to the database, treating gestational diabetes and drug therapy with metformin and/or insulin. Those that did not meet the theme and perspective of this study were excluded. Thirty-two articles were selected, where it was observed that insulin, as it has a lower transplacental passage, is still the drug of choice in the treatment of GDM, however, the need for several daily doses, difficulty in self-administration, stress resulting from use and gain of weight make adhesion difficult. However, the use of metformin during the first trimester of pregnancy, when previously used in polycystic ovaries, did not show teratogenic effects and demonstrated the benefits of reducing premature births and cesarean sections, reducing maternal obesity and fewer cases of macrosomia, jaundice and hypoglycemia neonatal. No differences were found between metformin and insulin for the risk of pre-eclampsia. Metformin is a pharmacological option with a similar profile to insulin in glycemic control. However, as it crosses the placental barrier and has less evidence of short- and long-term safety, there is still a need for more pharmacological and toxicological studies to better understand the use of metformin in pregnant patients.