Use of Glucagon-Like Peptide-1 Receptor Agonists in Women with Type 2 Diabetes Before Pregnancy: Addressing the Dilemma in A Real-World Setting

Billionnet C, Mitanchez D, Weill A, Nizard J, Alla F, Hartemann A, Jacqueminet S. Gestational diabetes and adverse perinatal outcomes from 716,152 births in France in 2012. Diabetologia. 2017;60(4):636–44. https://doi.org/10.1007/s00125-017-4206-6. https://pubmed.ncbi.nlm.nih.gov/28197657/.

Article  CAS  PubMed  PubMed Central  Google Scholar 

Murphy HR, Howgate C, O’Keefe J, Myers J, Morgan M, Coleman MA. Characteristics and outcomes of pregnant women with type 1 or type 2 diabetes: a 5-year national population-based cohort study. Lancet Diabetes Endocrinol. 2021;9(3):153–64. https://doi.org/10.1016/S2213-8587(20)30406-X. https://pubmed.ncbi.nlm.nih.gov/33516295/.

Article  PubMed  Google Scholar 

Singh GK, DiBari JN. Marked disparities in pre-pregnancy obesity and overweight prevalence among US women by race/ethnicity, nativity/immigrant status, and sociodemographic characteristics, 2012–2014. J Obes. 2019;10:2019:2419263. https://doi.org/10.1155/2019/2419263.

Article  Google Scholar 

Misra S, Holman N, Barron E, Knighton P, Warner J, Kar P, et al. Characteristics and care of young people with type 2 diabetes included in the national diabetes audit datasets for England. Diabet Med. 2023;40(1):e14940. https://doi.org/10.1111/dme.14940. https://pubmed.ncbi.nlm.nih.gov/36054265/.

Article  CAS  PubMed  Google Scholar 

Mackin ST, Nelson SM, Kerssens JJ, Wood R, Wild S, Colhoun HM, et al. Diabetes and pregnancy: national trends over a 15 year period. Diabetologia. 2018;61(5):1081–8. https://doi.org/10.1007/s00125-017-4529-3. https://pubmed.ncbi.nlm.nih.gov/29322220/.

PubMed  PubMed Central  Google Scholar 

Fadl HE, Simmons D. Trends in diabetes in pregnancy in Sweden 1998–2012. BMJ Open Diabtes Res Care. 2016;4(1):11. https://pubmed.ncbi.nlm.nih.gov/27547412/. e000221. doi: 10.1136/bmjdrc-2016-000221.

Google Scholar 

Group HSCR, Metzger BE, Lowe LP, Dyer AR, Trimble ER, Chaovarindr U et al. Hyperglycemia and adverse pregnancy outcomes. New Engl J Med 2008:8;358(19):1991–2002. https://doi.org/10.1056/NEJMoa0707943https://pubmed.ncbi.nlm.nih.gov/18463375/

Clausen TD, Mathiesen E, Ekbom P, Hellmuth E, Mandrup-Poulsen T, Damm P. Poor pregnancy outcome in women with type 2 diabetes. Diabetes Care. 2005;28(2):323–8. https://doi.org/10.2337/diacare.28.2.323. https://pubmed.ncbi.nlm.nih.gov/15677787/.

Article  PubMed  Google Scholar 

Parellada CB, Ásbjörnsdóttir B, Ringholm L, Damm P, Mathiesen ER. Fetal growth in relation to gestational weight gain in women with Type 2 diabetes: an observational study. Diabet Med. 2014;31(12):26. https://doi.org/10.1111/dme.12558. https://pubmed.ncbi.nlm.nih.gov/25081349/.

Article  Google Scholar 

Management of Diabetes in Pregnancy: Standards of Care in Diabetes-2025. Diabetes Care. 2025;48(1 Suppl 1):1. https://doi.org/10.2337/dc25-S015

Article  Google Scholar 

Minis E, Stanford FC, Mahalingaiah S. Glucagon-like peptide-1 receptor agonists and safety in the preconception period. Current Opinion in Endocrinology. Diabetes Obes. 2023;30(6):1. https://doi.org/10.1097/MED.0000000000000835. https://pubmed.ncbi.nlm.nih.gov/37678163/.

Google Scholar 

Drummond RF, Seif KE, Reece A. Glucagon-like peptide-1 receptor agonist use in pregnancy: a review. AJOG. 2025;232(1):17–25. https://doi.org/10.1016/j.ajog.2024.08.024. https://pubmed.ncbi.nlm.nih.gov/39181497/.

Article  CAS  Google Scholar 

Imbroane MR, LeMoine F, Nau CT. Preconception glucagon-like peptide-1 receptor agonist use associated with decreased risk of adverse obstetrical outcomes. AJOG. 2025;233(2):116. https://doi.org/10.1016/j.ajog.2025.01.019.e1-116.e7 https://pubmed.ncbi.nlm.nih.gov/39848396/

Article  CAS  Google Scholar 

Zheng L, Yang L, Guo Z, Yao N, Zhang S, Pu P. Obesity and its impact on female reproductive health: unraveling the connections. Front Endocrinol (Lausanne). 2024;14(9):1326546. https://doi.org/10.3389/fendo.2023.1326546.

Article  PubMed  PubMed Central  Google Scholar 

Boots C, Stephenson MD. Does obesity increase the risk of miscarriage in spontaneous conception: a systematic review. Semin Reprod Med. 2011;29(6):507–13. https://doi.org/10.1055/s-0031-1293204. https://pubmed.ncbi.nlm.nih.gov/22161463/.

Article  PubMed  Google Scholar 

Metwally M, Ong KJ, Ledger WL, Li TC. Does high body mass index increase the risk of miscarriage after spontaneous and assisted conception? A meta-analysis of the evidence. Fertil Steril. 2008;90(3):714–26. https://doi.org/10.1016/j.fertnstert.2007.07.1290.

Article  PubMed  Google Scholar 

Caldwell AE, Gorczyca AM, Bradford AP, Nicklas JM, Montgomery RN, Smyth H, Pretzel S. Effectiveness of preconception weight loss interventions on fertility in women: a systematic review and meta-analysis. Fertil Steril. 2024;122(2):326–40. https://pubmed.ncbi.nlm.nih.gov/38408693/.

Article  PubMed  PubMed Central  Google Scholar 

Maya J, Pant D, Fu Y, James K, Batlle C, Hsu S. Gestational weight gain and pregnancy outcomes after GLP-1 receptor agonist discontinuation. JAMA. 2025;e2520951. https://doi.org/10.1001/jama.2025.20951.

Article  CAS  Google Scholar 

Maya J, Pant D, James K. 1214-P: Prepregnancy use of glucagon-like peptide 1 receptor agonists and gestational weight gain in type 2 diabetes. American Diabetes Association https://doiorg/102337/db24-1214-P.2024;73:1214–P.

Varughese MS, O’Mahony F, Varadhan L. GLP-1 receptor agonist therapy and pregnancy: Evolving and emerging evidence. Clininal Med (London). 2025;25(2):100298. https://doi.org/10.1016/j.clinme.2025.100298. https://pubmed.ncbi.nlm.nih.gov/39993530/.

Article  Google Scholar 

EMA, Ozempic. EPAR - Product information. https://wwwemaeuropaeu/en/medicines/human/EPAR/ozempic.30/09/2025

FDA. HIGHLIGHTS OF PRESCRIBING INFORMATION for OZEMPIC. https://wwwaccessdatafdagov/drugsatfda_docs/label/2025/209637s035,10/2025.

Wyckoff JA, Lapolla A, Asias-Dinh BD, Barbour LA, Brown FM, Catalan PM, et al. Preexisting Diabetes and Pregnancy: An Endocrine Society and European Society of Endocrinology Joint Clinical Practice Guideline. J Clin Endocrinol Metab. 2025;110(9):7. https://doi.org/10.1210/clinem/dgaf288. https://pubmed.ncbi.nlm.nih.gov/40652453/.

Article  Google Scholar 

Rubino D, Abrahamsson N, Davies M, Hesse D, Greenway FL, Jensen C, et al. Effect of continued weekly subcutaneous semaglutide vs placebo on weight loss maintenance in adults with overweight or obesity: the STEP 4 randomized clinical trial. JAMA. 2021;325(14):1414–25. https://doi.org/10.1001/jama.2021.3224.

Article  CAS  PubMed  PubMed Central  Google Scholar 

Wilding JPH, Batterham RL, Davies M, Gaal LFV, Kandler K, Konakli K, et al. Weight regain and cardiometabolic effects after withdrawal of semaglutide: The STEP 1 trial extension. Diabetes Obes Metabolism. 2022;24(8):1553–64. https://doi.org/10.1111/dom.14725. https://pubmed.ncbi.nlm.nih.gov/35441470/.

Article  CAS  Google Scholar 

Piccini S, Favacchio G, Panico C, Morenghi E, Folli F, Mazziotti G, et al. Time-dependent effect of GLP-1 receptor agonists on cardiovascular benefits: a real-world study. Cardiovasc Diabetol. 2023;22(1):25. https://doi.org/10.1186/s12933-023-01800-z. https://pubmed.ncbi.nlm.nih.gov/36966321/.

Article  Google Scholar 

Secher AL, Mathiesen ER, Andersen HU, Damm P, Ringholm L. Severe hypoglycemia in pregnant women with type 2 diabetes-A relevant clinical problem. Diabetes Res Clin Pract. 2013;102(2):e17–8. https://doi.org/10.1016/j.diabres.2013.09.011. https://pubmed.ncbi.nlm.nih.gov/24138823/.

Article  PubMed  Google Scholar 

Ásbjörnsdóttir B, Vestgaard M, Ringholm L, Andersen LLT, Jensen DM, Damm P, Mathiesen ER. Effect of motivational interviewing on gestational weight gain and fetal growth in pregnant women with type 2 diabetes. BMJ Open. 2019;7(1):7. https://doi.org/10.1136/bmjdrc-2019-000733. https://pubmed.ncbi.nlm.nih.gov/31798895/.

Google Scholar 

Dao K, Shechtman S, Weber-Schoendorfer C, Diav-Citrin O, Murad RH, Berlin M, et al. Use of GLP1 receptor agonists in early pregnancy and reproductive safety: a multicentre, observational, prospective cohort study based on the databases of six Teratology Information Services. BMJ Open. 2024;24(144):e083550. https://doi.org/10.1136/bmjopen-2023-083550. https://pubmed.ncbi.nlm.nih.gov/38663923/.

Article  Google Scholar 

Parker CH, Slattery C, Brennan DJ, Roux, CWl. Glucagon-like peptide 1 (GLP-1) receptor agonists’ use during pregnancy: Safety data from regulatory clinical trials. Diabetes Obes Metabolism. 2025;27(8):4102–8. https://doi.org/10.1111/dom.16437. https://pubmed.ncbi.nlm.nih.gov/40329607/.

Article  Google Scholar 

Dumolt JH, Rosario FJ, Kramer AC, Horwitz S, Powell TL, Jansson T. Maternal glucagon-like peptide-1 is positively associated with fetal growth in pregnancies complicated with obesity. Clininal Med (London). 2023;137(8):663–78. https://doi.org/10.1042/CS20220890. https://pubmed.ncbi.nlm.nih.gov/37014924/.

Article  CAS  Google Scholar 

Collins L, Costello RA. Glucagon-Like Peptide-1 Receptor Agonists. National Library of Medicine; 2025.

Google Scholar 

Qiao L, Lu C, Zang T, Dzyuba B, Shao J. Maternal GLP-1 receptor activation inhibits fetal growth. Am J Physiol Endocrinol Metab. 2024;326(3):1. https://doi.org/10.1152/ajpendo.00361.2023. https://pubmed.ncbi.nlm.nih.gov/38197791/.

Article  Google Scholar 

Nauck MA, Quast DR, Wefers J, Meier JJ. GLP-1 receptor agonists in the treatment of type 2 diabetes - state-of-the-art. Mol Metabolism. 2021. https://doi.org/10.1016/j.molmet.2020.101102. https://pubmed.ncbi.nlm.nih.gov/33068776/. :46:101102.

Price SAL, Nankervis A. Considering the use of GLP-1 receptor agonists in women with obesity prior to pregnancy: a narrative review. Springer Nat Link. 2025;311(5):1241–7.

Comments (0)

No login
gif