Prescribing of Antidiabetic Medicines before, during and after Pregnancy: A Study in Seven European Regions
Charlton, Rachel A; Klungsøyr, Kari; Neville, Amanda J; Jordan, Sue; Pierini, Anna; de Jong-van den Berg, Lolkje T W; Bos, H Jens; Puccini, Aurora; Engeland, Anders; Gini, Rosa; Davies, Gareth; Thayer, Daniel; Hansen, Anne V; Morgan, Margery; Wang, Hao; McGrogan, Anita; Andersen, Anne-Marie Nybo; Dolk, Helen; Garne, Ester
Peer reviewed, Journal article
MetadataShow full item record
Aim: To explore antidiabetic medicine prescribing to women before, during and after pregnancy in different regions of Europe. Methods: A common protocol was implemented across seven databases in Denmark, Norway, The Netherlands, Italy (Emilia Romagna/Tuscany), Wales and the rest of the UK. Women with a pregnancy starting and ending between 2004 and 2010, (Denmark, 2004–2009; Norway, 2005–2010; Emilia Romagna, 2008–2010), which ended in a live or stillbirth, were identified. Prescriptions for antidiabetic medicines issued (UK) or dispensed (non-UK) during pregnancy and/or the year before or year after pregnancy were identified. Prescribing patterns were compared across databases and over calendar time. Results: 1,082,673 live/stillbirths were identified. Pregestational insulin prescribing during the year before pregnancy ranged from 0.27% (CI95 0.25–0.30) in Tuscany to 0.45% (CI95 0.43–0.47) in Norway, and increased between 2004 and 2009 in all countries. During pregnancy, insulin prescribing peaked during the third trimester and increased over time; third trimester prescribing was highest in Tuscany (2.2%) and lowest in Denmark (0.5%). Of those prescribed an insulin during pregnancy, between 50.5% in Denmark and 88.8% in the Netherlands received an insulin analogue alone or in combination with human insulin, this proportion increasing over time. Oral products were mainly metformin and prescribing was highest in the 3 months before pregnancy. Metformin use during pregnancy increased in some countries. Conclusion: Pregestational diabetes is increasing in many areas of Europe. There is considerable variation between and within countries in the choice of medication for treating pregestational diabetes in pregnancy, including choice of insulin analogues and oral antidiabetics, and very large variation in the treatment of gestational diabetes despite international guidelines.
PublisherPublic Library of Science
CopyrightCopyright 2016 Charlton et al.
Except where otherwise noted, this item's license is described as This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.