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Furthermore, the absence of fetal adverse effects such as malformations and hypoglycemia makes GLIB an acceptable treatment option for patients with T2DM during pregnancy.[174,175] In a meta-analysis including one RCT from India, the outcomes of GLIB, metformin, and insulin were assessed

For instance, genes such as CREM , SPATA4 , SPATA5 , SPATA6 , and MTHFR display hypermethylated promoter regions under diabetic conditions, potentially silencing essential genes for spermatogenesis and reducing fertility in diabetic patients [174,175,176]

Association of Organic Cation Transporter 1 With Intolerance to Metformin in Type 2 Diabetes: A GoDARTS Study

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In some cases, these spasms are reported as being severe enough to warrant anti-convulsant medication (R)