Among the following antidiabetic agents used in pregnancy, which one does NOT cross the placenta?
- A Insulin ✓
- B Glibenclamide
- C Metformin
- D Empagliflozin
Correct answer: A. Insulin
Explanation
Insulin, being a large peptide degraded by placental insulinases, does not cross the placenta in any clinically meaningful amount, which is why it remains the gold standard agent when pharmacotherapy is needed in pregnancy. Metformin crosses freely and reaches fetal levels comparable to maternal levels. Glibenclamide was long thought not to cross but cord blood studies show measurable transfer. SGLT2 inhibitors are avoided entirely in pregnancy because of fetal renal and skeletal concerns demonstrated in animal data.
Reference: Williams Obstetrics, 26th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.