Introduction: Gestational diabetes mellitus (GDM) is the most common pregnancy complication worldwide and is expected to increase in prevalence due to rising maternal obesity, type II diabetes mellitus, and associated conditions. The current standard of pharmacological therapy for GDM is insulin, regardless of gestational age at diagnosis. However, oral antidiabetic agents such as glyburide and acarbose are widely used in the treatment of GDM and are often preferred over insulin therapy due to their ease of use and relatively low cost. The timing of oral agent initiation is an important clinical decision in the care of patients diagnosed with GDM. A comparison of maternal outcomes associated with oral agent initiation at differing gestational ages has yet to be studied. The purpose of this study is to assess whether earlier gestational age at initiation of oral medications for treatment of GDM is associated with increase in adverse pregnancy outcomes or transition to insulin.
Methods: This was a retrospective cohort study of patients treated for GDM class A2 from 2011 to 2016 at a single center with standardized approach for treatment of GDM, including use of acarbose and/or glyburide. We compared frequency of maternal outcomes (preterm birth