Are DPP-4 inhibitors safe in pregnancy?
Pregnancy: All DPP-4 inhibitors are considered Pregnancy Category B because safety in humans has not been proven in adequate and well-controlled studies. Insulin is the drug of choice in patients with diabetes who are pregnant.
Can oral hypoglycemic agents be used in pregnancy?
Currently both glyburide and metformin are classified by FDA as Category B drugs in pregnancy. The oral hypoglycemic agents are safe options in gestational diabetes mellitus. They are promising options in low resource countries.
When do you not use DPP-4 inhibitors?
GENERAL. Contraindicated in patients with hypersensitivity reaction to sitagliptin, saxagliptin, linagliptin, or alogliptin. Do not use in diabetic ketoacidosis. Do not use as therapy for type 1 diabetes mellitus.
Which antidiabetic is safe in pregnancy?
Insulin is the gold standard for treatment of hyperglycemia during pregnancy, when lifestyle measures do not maintain glycemic control during pregnancy. However, recent studies have suggested that certain oral hypoglycemic agents (metformin and glyburide) may be safe and be acceptable alternatives.
Do DPP 4 inhibitors cause hypoglycemia?
DPP-4 inhibitors don’t cause low blood glucose, a condition called hypoglycemia. But you’re at risk for low blood glucose if you also take diabetes pills or insulin that can cause hypoglycemia.
How much does DPP 4 lower A1C?
DPP4 inhibitors stimulate glucose-dependent insulin secretion and inhibit glucagon production. As monotherapy, they reduce the hemoglobin A1c level by about 0.6–0.8%.
What is the drug of choice for treating diabetes during pregnancy?
Insulin is the traditional first-choice drug for blood sugar control during pregnancy because it is the most effective for fine-tuning blood sugar and it doesn’t cross the placenta. Therefore, it is safe for the baby. Insulin can be injected with a syringe, an insulin pen, or through an insulin pump.
What is the best choice of oral diabetic agent for the pregnant patient?
IN BRIEF The oral agents glyburide and metformin are both recommended by many professional societies for the treatment of gestational diabetes mellitus (GDM). Both therapeutic modalities have published safety and efficacy data, but there remains much debate among experts.
Do DPP-4 inhibitors cause hypoglycemia?
Which insulin is best for gestational diabetes?
However, the newer rapid-acting insulin analogs lispro and aspart, when compared to regular human insulin, demonstrate both efficacy and safety for the treatment of diabetes during pregnancy. NPH insulin is the only basal insulin that has been studied in pregnancy.
Why the risk of hypoglycemia is low with DPP-4 inhibitors?
DPP-4 inhibitors augment insulin secretion in a glucose-dependent manner, thus preventing hypoglycemia when used as monotherapy or in combination with antidiabetic agents which are known not to increase rates of hypoglycemia [Nauck et al. 2009].
Are there any DPP-4 inhibitors with low hypoglycemia?
Low Hypoglycemia Risk: A major benefit of DPP-4 inhibitors is their low risk of hypoglycemia. As monotherapy, alogliptin, linagliptin, saxagliptin, and sitagliptin have a 0.6% to 6.6% incidence of hypoglycemia. In clinical studies, linagliptin monotherapy had a 6.6% risk of hypoglycemia versus a 0.6% risk for sitagliptin.
What are the effects of DPP-4 in diabetes?
Glucose-Lowering Effects: DPP-4 inhibitors effectively reduce both fasting and postprandial glucose levels.
Can a person with diabetes be hypoglycemic during pregnancy?
Your diabetes medication doses are too effective at lowering blood sugar and need to be modified. This is the most common reason for hypoglycemia during pregnancy. Hypoglycemia can occur in pregnant women without diabetes, but it’s much more likely to be seen in women taking insulin.
Can a DPP-4 inhibitor be used with a GLP-1 agonist?
Based on a lack of robust data regarding the safety and efficacy of simultaneous use of DPP-4 inhibitors and GLP-1 agonists, the combination is not recommended. The FDA, ADA, and AACE do not support the use of this combination in patients with type 2 diabetes. 46