Empagliflozin, metformin and insulin degludec, during pregnancy: a case report

Excerpt

In the last 10 years, several new oral hypoglycemic agents and novel insulin analogs have been introduced for type 2 diabetes therapy which demonstrated to be a valid and safety support in terms of blood glucose and weight control as well as cardiovascular protection. Among them, empagliflozin, by inhibiting the sodium-glucose co-transporter 2 (SGLT-2) at the proximal convoluted tubule level, decreases renal glucose reabsorption and favors calories loss. Insulin degludec is an extra-long-acting insulin analog associated with reduced glycemic variability and reduced hypoglycemic events as compared to glargine. Metformin, in use since many years for diabetes treatment, is a biguanide lowering blood glucose by reducing hepatic glucose output, increasing insulin sensitivity and enhancing peripheral glucose uptake. In Italy, none of these drugs is approved for use during pregnancy. …