Current diabetes reports

Use of Diabetes Medicines That Activate GLP-1 Receptors in Women with Type 2 Diabetes Before Pregnancy: Real-World Challenges

Updated

Abstract

A total of 2,994 women with type 2 diabetes exposed to glucagon-like peptide-1 receptor agonists in early pregnancy showed no increased risk of malformations.

  • Animal studies suggest potential risks of fetal loss, malformations, and adverse fetal growth associated with GLP-1RA exposure.
  • Three cohort studies and one prospective study found no evidence of increased malformations in pregnancies exposed to GLP-1RAs compared to unexposed ones.
  • Observational data from 168 pregnancies exposed to GLP-1RAs indicate no increased risk of miscarriage or adverse fetal growth.
  • Women with type 2 diabetes are recommended to use contraception and discontinue GLP-1RAs two months prior to planned pregnancy.
  • Existing human evidence does not support terminating a pregnancy if a woman with type 2 diabetes becomes unintentionally pregnant while using GLP-1RAs.

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Full Text

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Funding

Competing interests

Declarations. Human/Animal Studies Informed Consent: This article does not contain any studies with human or animal subjects performed by any of the authors. Competing interests: LR has received a grant from Novo Nordisk Foundation (grant number: NNF24OC0091713) for an investigator sponsored randomized controlled trial for which Mylife Diabetes Care AG donates insulin pumps and accessories and Abbott donates continued glucose monitoring devices, and participated in the European Association for the Study of Diabetes annual meeting 2023 as an invite by Novo Nordisk. SH has received funding from Independent Research Fund Denmark, Novo Nordisk and Boehringer Ingelheim. PD has participated in clinical studies on the use of insulin in pregnant women with preexisting diabetes in collaboration with Novo Nordisk, but no personal honorarium was involved. AA and ERM declare no competing interests.
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