Antidiabetic Therapy during Pregnancy: The Prescription Pattern in Italy

• Published in: International journal of environmental research and public health Vol. 20; no. 23; p. 7139
• Main Authors: Locatelli, Anna, Ornaghi, Sara, Terzaghi, Alessandra, Belleudi, Valeria, Fortinguerra, Filomena, Poggi, Francesca Romana, Perna, Serena, Trotta, Francesco, MoM-Net Group
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 04.12.2023
• Subjects: Antidiabetics; Clinical medicine; Cross-Sectional Studies; Diabetes, Gestational - drug therapy; Diabetes, Gestational - epidemiology; Fasting; Female; Gestational diabetes; Glucose; Humans; Hyperglycemia; Hypoglycemic Agents - therapeutic use; Insulin; Italy - epidemiology; Metabolism; Obesity; Population-based studies; Preeclampsia; Pregnancy; Prescription drugs; Prescriptions; Womens health; Italy; gestational diabetes mellitus; pregestational diabetes mellitus; antidiabetic drugs; pregnancy; prescription pattern
• ISSN: 1660-4601; 1661-7827; 1660-4601
• DOI: 10.3390/ijerph20237139

Pregestational and gestational diabetes mellitus are relevant complications of pregnancy, and antidiabetic drugs are prescribed to obtain glycemic control and improve perinatal outcomes. The objective of this study was to describe the prescription pattern of antidiabetics before, during and after pregnancy in Italy and to evaluate its concordance with the Italian guideline on treatment of diabetes mellitus. A multi-database cross-sectional population study using a Common Data Model was performed. In a cohort of about 450,000 women, the prescribing profile of antidiabetics seemed to be in line with the Italian guideline, which currently does not recommend the use of oral antidiabetics and non-insulin injection, even if practice is still heterogeneous (up to 3.8% in the third trimester used oral antidiabetics). A substantial variability in the prescription pattern was observed among the Italian regions considered: the highest increase was registered in Tuscany (4.2%) while the lowest was in Lombardy (1.5%). Women with multiple births had a higher proportion of antidiabetic prescriptions than women with singleton births both in the preconception period and during pregnancy (1.3% vs. 0.7%; 3.4% vs. 2.6%) and used metformin more frequently. The consumption of antidiabetics in foreign women was higher than Italians (second trimester: 1.8% vs. 0.9%, third trimester: 3.6% vs. 1.8%).