title: Glyburide for the treatment of gestational diabetes.
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.
  
  
  CONCLUSIONS
  Approximately 80% of patients with gestational diabetes who fail to respond to diet therapy can be treated effectively with glyburide.
authors.affiliation: Department of Obstetrics and Gynecology, University of Florida College of Medicine, Gainesville, Florida, USA.
authors.forename: Carrie J
authors.initials: CJ
authors.lastname: Kremer
authors.forename: Patrick
authors.initials: P
authors.lastname: Duff
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000032:analysis / Q000187:drug effects; D015331:Cohort Studies; D016001:Confidence Intervals; D016640:Diabetes, Gestational / Q000175:diagnosis* / Q000188:drug therapy*; D003927:Diet, Diabetic; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D005865:Gestational Age; D005905:Glyburide / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D008423:Maternal Age; D011247:Pregnancy; D011256:Pregnancy Outcome; D018566:Pregnancy, High-Risk; D011336:Probability; D011446:Prospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D001786:Blood Glucose; D005905:Glyburide