Aarhus University Seal / Aarhus Universitets segl

Antidiabetic medication use during pregnancy: An international utilization study

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaperJournal articleResearchpeer-review

  • Carolyn E. Cesta, Karolinska Institutet
  • ,
  • Jacqueline M. Cohen, Norwegian Institute of Public Health
  • ,
  • Laura Pazzagli, Karolinska Institutet
  • ,
  • Brian T. Bateman, Harvard University, Massachusetts General Hospital, Boston
  • ,
  • Gabriella Bröms, Karolinska Institutet, Karolinska Institut at Danderyds Hospital
  • ,
  • Kristjana Einarsdóttir, University of Iceland
  • ,
  • Kari Furu, Norwegian Institute of Public Health
  • ,
  • Alys Havard, University of New South Wales (UNSW) Australia
  • ,
  • Anna Heino, The National Institute for Health and Welfare
  • ,
  • Sonia Hernandez-DIaz, Harvard School of Public Health
  • ,
  • Krista F. Huybrechts, Harvard University
  • ,
  • Øystein Karlstad, Norwegian Institute of Public Health
  • ,
  • Helle Kieler, Karolinska Institutet
  • ,
  • Jiong Li
  • Maarit K. Leinonen, The National Institute for Health and Welfare
  • ,
  • Hanne L. Gulseth, Norwegian Institute of Public Health
  • ,
  • Duong Tran, University of New South Wales (UNSW) Australia
  • ,
  • Yongfu Yu
  • Helga Zoega, University of Iceland, University of New South Wales (UNSW) Australia
  • ,
  • Ingvild Odsbu, Karolinska Institutet

Objective Diabetes 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 methods Data 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. Results Prevalence of any ADM use in 5 279 231 pregnancies was 3% (n=147 999) and varied from under 2% (Denmark, Norway, and Sweden) to above 5% (Australia and US). Insulin was the most used ADM, and metformin was the most used oral hypoglycemic agent with increasing use over time in all countries. In 11.4%-62.5% of pregnancies with prepregnancy use, ADM (primarily metformin) was discontinued. When ADM treatment was initiated in late pregnancy for treatment of gestational diabetes mellitus, insulin was most often dispensed, except in the US, where glibenclamide was most often used. Conclusions Prevalence and patterns of use of ADM classes varied between countries and over time. While insulin remained the most common ADM used in pregnancy, metformin use increased significantly over the study period.

Original languageEnglish
Article number000903
JournalBMJ Open Diabetes Research and Care
Volume7
Issue1
Number of pages12
ISSN2052-4897
DOIs
Publication statusPublished - 2019

    Research areas

  • drug utilization, gestational diabetes mellitus, insulin, oral antidiabetics, pharmacoepidemiology, population-based studies, pregestational diabetes, pregnancy

See relations at Aarhus University Citationformats

ID: 172165026