Prescribing of Antidiabetic Medicines before, during and after Pregnancy: A Study in Seven European Regions (original) (raw)
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Antidiabetic medication use during pregnancy: an international utilization study
BMJ Open Diabetes Research & Care, 2019
ObjectiveDiabetes in pregnancy and consequently the need for treatment with antidiabetic medication (ADM) has become increasingly prevalent. The prevalence and patterns of use of ADM in pregnancy from 2006 onward in seven different countries was assessed.Research design and methodsData sources included individually linked data from the nationwide health registers in Denmark (2006–2016), Finland (2006–2016), Iceland (2006–2012), Norway (2006–2015), Sweden (2006–2015), state-wide administrative and claims data for New South Wales, Australia (2006–2012) and two US insurance databases: Medicaid Analytic eXtract (MAX; 2006–2012, public) and IBM MarketScan (2012–2015, private). The prevalence of ADM use was calculated as the proportion of pregnancies with at least one filled prescription of an ADM in the 90 days before pregnancy or within the three trimesters of pregnancy.ResultsPrevalence of any ADM use in 5 279 231 pregnancies was 3% (n=147 999) and varied from under 2% (Denmark, Norway...
Prevalence, trends, and patterns of use of antidiabetic medications among pregnant women, 2001-2007
Obstetrics and gynecology, 2013
To describe the prevalence, trends, and patterns in use of antidiabetic medications to treat hyperglycemia and insulin resistance before and during pregnancy in a large U.S. cohort of insured pregnant women. Pregnancies resulting in live births were identified (N=437,950) from 2001 to 2007 among 372,543 females 12-50 years of age at delivery from 10 health maintenance organizations participating in the Medication Exposure in Pregnancy Risk Evaluation Program. Information for these descriptive analyses, including all antidiabetic medications dispensed during this period, was extracted from electronic health records and newborn birth certificates. A little more than 1% (1.21%) of deliveries were to women dispensed antidiabetic medication in the 120 days before pregnancy. Use of antidiabetic medications before pregnancy increased from 0.66% of deliveries in 2001 to 1.66% of deliveries in 2007 (P<.001) because of an increase in metformin use. Most women using metformin before pregnan...
European Journal of Epidemiology, 2011
This study aimed to use a population-based Prescription Database to explore later development of diabetes in women registered with gestational diabetes mellitus (GDM) and/or preeclampsia in the Medical Birth Registry of Norway (MBRN) during 2004-8. We used two nationwide Norwegian registries, the Norwegian Prescription Database and the MBRN, to explore the onset of later diabetes after pregnancy complications, indicated by receiving prescriptions of drugs used to treat diabetes, in 230,000 women giving birth in 2004-8. The mean follow-up of the study cohort was 3.7 years. Five years after pregnancy, about 19 and 2% of women with GDM and preeclampsia, respectively, received drugs used to treat diabetes, compared to 0.5% of those without these complications. The risk of being dispensed drugs used to treat diabetes within the first years after pregnancy was estimated to be 41 times (95% CI: 35-47) and 3.0 times (95% CI: 2.4-3.6) higher in women with GDM and preeclampsia, respectively, compared to women without these pregnancy complications. Women with pregnancies complicated with preeclampsia or GDM had an increased risk of later diabetes, especially those having GDM. If the increase in frequency of GDM observed in MBRN in recent years is real, a further increase in diabetic women can be expected.
Medication prescriptions before, during and after pregnancy in Italy: a population-based study
2021
BACKGROUND Monitoring medicine prescriptions in pregnancy is an aspect of extreme interest in term of public health. METHODS A retrospective prevalence study using administrative healthcare databases was performed in order to evaluate medication prescriptions in Italy. A cohort of 274,938 pregnant women (15-49 years) residing in three Italian regions (Emilia-Romagna, Lazio, Puglia), who delivered in 2014-2017, were enrolled. The prevalence of medication use was estimated as the proportion of pregnant women with any medication prescription in each of the following five trimesters: 1 before pregnancy (pre-T), 3 during pregnancy (1st TP, 2nd TP, 3rd TP) and 1 after pregnancy (post-T). RESULTS About 80% of enrolled pregnant women received at least one prescription during pregnancy, 36.5% before pregnancy and 50.7% in the post-partum. The most prescribed medicine was folic acid (42%), mostly used in 1st TP (35%). Progesterone use was concentrated in 1st TP (19%) and increased as the numb...
Cochrane Database of Systematic Reviews, 2010
Background-While most guidelines recommend the use of insulin in women whose pregnancies are affected by pre-existing diabetes, oral agents have obvious benefits for patient acceptability and adherence. It is necessary, however, to assess the effects of these anti-diabetic agents on maternal and infant health outcomes. Additionally, women with previous gestational diabetes mellitus are increasingly found to be predisposed to impaired glucose tolerance and, despite the potential need for intervention for these women, there has been little evidence about the use of oral anti-diabetic agents by these women pre-conceptionally or during a subsequent pregnancy. Objectives-To investigate the effect of oral anti-diabetic agents in women with pre-existing diabetes mellitus, impaired glucose tolerance or previous gestational diabetes planning a pregnancy or pregnant women with diabetes mellitus on maternal and infant health. The use of oral antidiabetic agents for management of gestational diabetes in a current pregnancy is evaluated in a separate Cochrane review. Search methods-We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (March 2010). Selection criteria-We included randomised and quasi-randomised trials.
International Journal of Pharmacy and Pharmaceutical Sciences, 2022
Objective: The prevalence of diabetes in pregnancy has increased in the U. S. The majority is gestational diabetes mellitus (GDM), with the remainder primarily preexisting type 1 diabetes and type 2 diabetes (pregestational diabetes, PGDM). The present study investigates the demographics and clinical differences between both types. Methods: This prospective study was conducted on ninety pregnant females with normal menstrual cycles before pregnancy. Demographics, oral glucose tolerance test (OGTT), and HbA1c were assessed. Results: There was a significant difference in the term of Oral glucose tolerance test Week 24 during fasting, Oral glucose tolerance test Week 24 after one hour, Oral glucose tolerance test Week 24 after two hours, Oral glucose tolerance test Week 24 after three hours, Oral glucose tolerance test Week 28 during fasting, Oral glucose tolerance test Week 28 after one hour, Oral glucose tolerance test Week 28 after two hours, Oral glucose tolerance test Week 28 after three hours, HbA1c week 24 and HbA1c week 28; p-value<0.05. Conclusion: pregnant women in this study who needed insulin were educated to self-monitoring of blood glucose, diet control, medication adherence, and exercise, and we adjusted the needed insulin dose for them with restrictive follow-up.
International Journal of Pharmacy and Pharmaceutical Sciences, 2022
Objective: The prevalence of diabetes in pregnancy has increased in the U. S. The majority is gestational diabetes mellitus (GDM), with the remainder primarily preexisting type 1 diabetes and type 2 diabetes (pregestational diabetes, PGDM). The present study investigates the demographics and clinical differences between both types. Methods: This prospective study was conducted on ninety pregnant females with normal menstrual cycles before pregnancy. Demographics, oral glucose tolerance test (OGTT), and HbA1c were assessed. Results: There was a significant difference in the term of Oral glucose tolerance test Week 24 during fasting, Oral glucose tolerance test Week 24 after one hour, Oral glucose tolerance test Week 24 after two hours, Oral glucose tolerance test Week 24 after three hours, Oral glucose tolerance test Week 28 during fasting, Oral glucose tolerance test Week 28 after one hour, Oral glucose tolerance test Week 28 after two hours, Oral glucose tolerance test Week 28 after three hours, HbA1c week 24 and HbA1c week 28; p-value<0.05. Conclusion: pregnant women in this study who needed insulin were educated to self-monitoring of blood glucose, diet control, medication adherence, and exercise, and we adjusted the needed insulin dose for them with restrictive follow-up.
Monitoring medicine prescriptions before, during and after pregnancy in Italy
PLOS ONE, 2023
Background The use of medications during pregnancy is a common event worldwide. Monitoring medicine prescriptions in clinical practice is a necessary step in assessing the impact of therapeutic choices in pregnant women as well as the adherence to clinical guidelines. The aim of this study was to provide prevalence data on medication use before, during and after pregnancy in the Italian population.
Pharmaceutical care of patients with gestational diabetes mellitus
Journal of Evaluation in Clinical Practice, 2008
Rationale, aims and objective To investigate whether the introduction of a programme of optimising drug treatment, intensive education and self‐monitoring of patients diagnosed with gestational diabetes mellitus (GDM) at an early stage (<20 gestational weeks), will improve management outcomes as determined by objective measures of patient knowledge about diabetes, glycaemia control, maternal/neonatal complications, and health‐related quality of life.Methods The study was a randomized, controlled, longitudinal, prospective clinical trial performed at Al‐Ain Hospital, Al‐Ain, United Arab Emirates. Over an 18‐month period, patients diagnosed with GDM were recruited and were randomly assigned to either an intervention or a control group, in a ratio of 3:2. Intervention patients received a structured pharmaceutical care service (including education and introduction of intensive self‐monitoring) while control patients received traditional services. Patients were followed up from time...