Antidiabetic drugs

Print
Date: August 2025, Version 1.0

Quick read

Type 2 diabetes during pregnancy should be treated with metformin, as well as insulin if required. Other antidiabetic drugs should not be used.

What are they?

Antidiabetic drugs are used to treat type 2 diabetes and include:
•    Insulin (Actrapid®, Humulin®, Hypurin®)
•    Metformin (Axpinet®, Glucophage®) (see the leaflet on Metformin use in pregnancy for more details)
•    Pioglitazone
•    Repaglinide
•    The SGL2 inhibitors – canagliflozin (Invokana®), dapagliflozin (Forxiga®), empagliflozin (Jardiance®), and ertugliflozin (Steglatro®)
•    The GLP-1 receptor agonists – dulaglutide (Trulicity®), exenatide (Bydureon®), liraglutide (Biolide®), lixisenatide, semaglutide (Rybelsus®, Wegovy®, Ozempic®) (see the leaflet on GLP-1 receptor antagonists for more details) 
•    The long-acting GIP and GLP-1 receptor agonist tirzepatide (Mounjaro®) (see the leaflet on GLP-1 receptor antagonists for more details)
•    The DPP-4 inhibitors – alogliptin (Vipidia®), linagliptin (Trajenta®), saxagliptin (Onglyza®), sitagliptin (Januvia®), and vildagliptin (Galvus®)
•    The sulfonylureas – gliclazide (Zicron®, Glydex®), glimepiride, glipizide (Minodiab®), and tolbutamide

Benefits

What are the benefits of using an antidiabetic drug in pregnancy?

Metformin and insulin help to control blood sugar levels in people with diabetes. 

It is very important that type 2 diabetes is well controlled during pregnancy, both for your health and to prevent pregnancy complications. 

Good blood sugar control reduces the ill effects caused by diabetes, including damage to the blood vessels, nerves, and eyes. 

High blood sugar in early pregnancy has been linked to an increased chance of certain congenital malformations in the baby.

Risks

Are there any risks of using an antidiabetic drug during pregnancy?

Metformin and insulin are safe to use in pregnancy. Please see the separate Bumps leaflet for further information.

There is very little information about using other types of antidiabetic drug in pregnancy. While these drugs do not seem to be harmful to the baby, more research is needed to confirm this. As a precaution, they are avoided in pregnancy.

Alternatives

Are there any alternatives to taking an antidiabetic medicine?

No. If you were taking a drug to treat Type 2 diabetes before pregnancy, you will need to keep taking diabetes medicines during pregnancy. Metformin, sometimes with insulin, is the recommended treatment during pregnancy and other antidiabetic medicines are avoided.

If you are planning a pregnancy and have type 2 diabetes, please speak to your GP or specialist to make sure you are taking the most suitable medication. If you have an unplanned pregnancy while taking an antidiabetic drug, you should be reviewed at the earliest opportunity by your GP or specialist. In this case, you should carry on with the drug you are taking until your appointment, as uncontrolled diabetes is risky for you and your baby.

No treatment

What if I prefer not to take medicines during pregnancy?

It is very important that diabetes is correctly treated during pregnancy to reduce the chance of complications for you and your baby.  

Your doctor will be happy to discuss any concerns about medicines prescribed in pregnancy.

Will I or my baby need extra monitoring?

All pregnant women in the UK will be offered a very detailed anomaly scan, usually at around 20 weeks of pregnancy, as part of their routine antenatal care. Taking an antidiabetic drug in early pregnancy is not expected to cause problems that would require any extra monitoring of your baby. Women with diabetes are likely to be more closely monitored during pregnancy and will be offered additional growth scans in the third trimester.

Are there any risks to my baby if the father has taken an antidiabetic drug?

We do not expect any increased risk to your baby if the father takes an antidiabetic drug.

Who can I talk to if I have questions?

If you have any questions regarding the information in this leaflet, please discuss them with your health care provider. They can access more detailed medical and scientific information from www.uktis.org.

How can I help to improve drug safety information for pregnant women in the future?

Our online reporting system (MyBump Portal) allows women who are currently pregnant to create a secure record of their pregnancy, collected through a series of questionnaires. You will be asked to enter information about your health, whether or not you take any medicines, your pregnancy outcome and your child's development. You can update your details at any time during pregnancy or afterwards. This information will help us better understand how medicines affect the health of pregnant women and their babies. Please visit the MyBump Portal to register.

General information
Sadly, miscarriage and birth defects can occur in any pregnancy.

Miscarriage occurs in about 1 in every 5 pregnancies, and 1 in every 40 babies are born with a birth defect. This is called the ‘background risk’ and happens whether medication is taken or not.

Most medicines cross the placenta and reach the baby. For many medications this is not a problem. However, some medicines can affect a baby’s growth and development.

If you take regular medication and are planning to conceive, you should discuss whether your medicine is safe to continue with your doctor/health care team before becoming pregnant. If you have an unplanned pregnancy while taking a medicine, you should tell your doctor as soon as possible.

If a new medicine is suggested for you during pregnancy, please make sure that the person prescribing it knows that you are pregnant. If you have any concerns about a medicine, you can check with your doctor, midwife or pharmacist.

Our Bumps information leaflets provide information about the effects of medicines in pregnancy so that you can decide, together with your healthcare provider, what is best for you and your baby.