Prospective observational study to establish predictors of glyburide success in women with gestational diabetes mellitus.
OBJECTIVE
To establish parameters associated with therapeutic success in gestational diabetics treated with glyburide.


METHODS
A total of 69 gestational diabetics who failed dietary therapy were treated with glyburide. Inadequate glycemic control on maximum dose glyburide (10 mg b.i.d.) was considered treatment failure. The glyburide failure rate was calculated and factors that might predict success with glyburide were analyzed between the success and failure groups using chi(2) or Student'st-tests.


RESULTS
The glyburide failure rate was 18.8%. Gestational age at glyburide initiation (p<0.01), pretreatment fasting blood sugars (p<0.001), and 1-hour postprandial values (p<0.001) were the only statistically significant factors between the two groups. Glyburide success was predicted if dietary failure occurred after 30 weeks, or fasting blood sugars were <110 mg/dl and 1-hour postprandials were <140 mg/dl (sensitivity 98%, specificity 65%).


CONCLUSIONS
Gestational diabetics who fail dietary therapy after 30 weeks gestation or have fasting blood sugars <110 mg/dl and 1-hour postprandials <140 mg/dl do well on glyburide therapy.
Chmait
Ramen
R
Division of Reproductive Medicine, University of California, San Diego, CA 92103, USA.
Dinise
Theresa
T
Moore
Thomas
T
D000328:Adult; D001786:Blood Glucose / Q000032:analysis; D016640:Diabetes, Gestational / Q000175:diagnosis* / Q000188:drug therapy*; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D005905:Glyburide / Q000008:administration & dosage*; D006801:Humans; D011237:Predictive Value of Tests; D011247:Pregnancy; D011256:Pregnancy Outcome; D011336:Probability; D011446:Prospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D016896:Treatment Outcome
D001786:Blood Glucose; D005905:Glyburide