A Pregnant Woman with Type 2 Diabetes Unintentionally Exposed to Metformin and Voglibose until the Second Trimester of Pregnancy: A Case Report

Yeo Un Kim; Jae Hoon Kwak; Se Hwan Yeo; Seong Su Moon; Young Sil Lee

doi:10.4093/jkd.2016.17.4.277

Journal List > J Korean Diabetes > v.17(4) > 1055037

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Kim, Kwak, Yeo, Moon, and Lee: A Pregnant Woman with Type 2 Diabetes Unintentionally Exposed to Metformin and Voglibose until the Second Trimester of Pregnancy: A Case Report

Case Report

J Korean Diabetes 2016;17(4):277-281.

Published online: 10 January 2016

DOI: https://doi.org/10.4093/jkd.2016.17.4.277

A Pregnant Woman with Type 2 Diabetes Unintentionally Exposed to Metformin and Voglibose until the Second Trimester of Pregnancy: A Case Report

Yeo Un Kim, Jae Hoon Kwak, Se Hwan Yeo, Seong Su Moon, Young Sil Lee

Department of Internal Medicine, Dongguk University College of Medicine, Gyeongju, Korea

Corresponding author: Young Sil Lee Department of Internal Medicine, Dongguk University College of Medicine, 87 Dongdae-ro, Gyeongju 780-350, Korea, E-mail: ysbae28@hanmail.net

Received 9 December 2015 Revised 13 January 2016 Accepted 23 March 2016

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Use of oral hypoglycemic agents during pregnant women with type 2 diabetes is controversial due to safety issues. Recently, randomized controlled trials support short-term safety of glyburide and metformin for the treatment of gestational diabetes mellitus. However, long-term safety data are not available. Moreover, use of oral hypoglycemic agents, except for metformin and glyburide, during pregnancy were limited to a few case reports. We report the case of a pregnant woman with type 2 diabetes unintentionally exposed to metformin and voglibose in addition to lercanidipine and bisoprolol during fetal organogenesis. The patient was continuously exposed to oral agents because we were not aware of her pregnancy until 22 weeks of gestation. After pregnancy was confirmed, we replaced oral hypoglycemic agents with insulin and discontinue beta-blockers. Delivery occurred without maternal or fetal complications.

Keywords: Diabetes mellitus type 2, Hypoglycemic agents, Pregnancy

References

1. American Diabetes Association. Management of diabetes in pregnancy. Diabetes Care. 2015; 38(Suppl 1):S77–9.

2. Holt RI, Lambert KD. The use of oral hypoglycaemic agents in pregnancy. Diabet Med. 2014; 31:282–91.

3. Yaris F, Yaris E, Kadioglu M, Ulku C, Kesim M, Kalyoncu NI. Normal pregnancy outcome following inadvertent exposure to rosiglitazone, gliclazide, and atorvastatin in a diabetic and hypertensive woman. Reprod Toxicol. 2004; 18:619–21.

4. Kolagasi O, Sari F, Akar M, Sari R. Normal pregnancy and healthy child after continued exposure to gliclazide and ramipril during pregnancy. Ann Pharmacother. 2009; 43:147–9.

5. HAPO Study Cooperative Research Group. Metzger BE, Lowe LP, Dyer AR, Trimble ER, Chaovarindr U, Coustan DR, Hadden DR, McCance DR, Hod M, McIntyre HD, Oats JJ, Persson B, Rogers MS, Sacks DA. Hyperglycemia and adverse pregnancy outcomes. N Engl J Med. 2008; 358:1991–2002.

6. Langer O, Conway DL, Berkus MD, Xenakis EM, Gonzales O. A comparison of glyburide and insulin in women with gestational diabetes mellitus. N Engl J Med. 2000; 343:1134–8.

7. Rowan JA, Hague WM, Gao W, Battin MR, Moore MP. MiG Trial Investigators. Metformin versus insulin for the treatment of gestational diabetes. N Engl J Med. 2008; 358:2003–15.

8. Vanky E, Salvesen KA, Heimstad R, Fougner KJ, Romundstad P, Carlsen SM. Metformin reduces pregnancy complications without affecting androgen levels in pregnant polycystic ovary syndrome women: results of a randomized study. Hum Reprod. 2004; 19:1734–40.

9. Morin-Papunen L, Rantala AS, Unkila-Kallio L, Tiitinen A, Hippeläinen M, Perheentupa A, Tinkanen H, Bloigu R, Puukka K, Ruokonen A, Tapanainen JS. Metformin improves pregnancy and live-birth rates in women with polycystic ovary syndrome (PCOS): a multicenter, double-blind, placebo-controlled randomized trial. J Clin Endocrinol Metab. 2012; 97:1492–500.

10. Coustan DR. Pharmacological management of gestational diabetes: an overview. Diabetes Care. 2007; 30(Suppl 2):S206–8.

11. Wilton LV, Pearce GL, Martin RM, Mackay FJ, Mann RD. The outcomes of pregnancy in women exposed to newly marketed drugs in general practice in England. Br J Obstet Gynaecol. 1998; 105:882–9.

12. Towner D, Kjos SL, Leung B, Montoro MM, Xiang A, Mestman JH, Buchanan TA. Congenital malformations in pregnancies complicated by NIDDM. Diabetes Care. 1995; 18:1446–51.

13. Podymow T, August P. Update on the use of antihypertensive drugs in pregnancy. Hypertension. 2008; 51:960–9.

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