Glyburide for the treatment of gestational diabetes

Am J Obstet Gynecol. 2004 May;190(5):1438-9. doi: 10.1016/j.ajog.2004.02.032.

Abstract

Objective: This study was undertaken to evaluate the effectiveness of glyburide in patients with gestational diabetes who failed diet therapy.

Methods: Patients who were beyond the first trimester and who failed to achieve satisfactory glucose control with diet therapy were treated with glyburide, at a starting dose of 2.5 mg daily. The dose was increased in increments to a maximum of 20 mg/day. The main treatment outcome was achievement of satisfactory glucose control, defined as a mean plasma fasting glucose 90 mg % or less and mean 1-hour postprandial plasma glucose determinations 135 mg % or less. Patients who failed to achieve satisfactory control were treated with twice-daily doses of insulin.

Results: During the period July 2001 through December 2002, we managed 197 patients with gestational diabetes. One-hundred twenty-four patients responded to diet alone; 73 were treated with glyburide. Of the 73 patients, 59 (81%, 95% CI 76.4-85.6) achieved satisfactory glucose control with glyburide; 44 women required 7.5 mg/day or less. Eleven of the 59 women (19%) had macrosomic infants. Eight patients (11%) experienced noticeable side effects related to glyburide; only 1 patient discontinued treatment.

Conclusion: Approximately 80% of patients with gestational diabetes who fail to respond to diet therapy can be treated effectively with glyburide.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Blood Glucose / analysis
  • Blood Glucose / drug effects
  • Cohort Studies
  • Confidence Intervals
  • Diabetes, Gestational / diagnosis*
  • Diabetes, Gestational / drug therapy*
  • Diet, Diabetic
  • Dose-Response Relationship, Drug
  • Drug Administration Schedule
  • Female
  • Follow-Up Studies
  • Gestational Age
  • Glyburide / administration & dosage*
  • Glyburide / adverse effects
  • Humans
  • Maternal Age
  • Pregnancy
  • Pregnancy Outcome*
  • Pregnancy, High-Risk
  • Probability
  • Prospective Studies
  • Risk Assessment
  • Severity of Illness Index
  • Treatment Outcome

Substances

  • Blood Glucose
  • Glyburide