Glyburide for the treatment of gestational diabetes.
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.
Kremer
Carrie J
CJ
Department of Obstetrics and Gynecology, University of Florida College of Medicine, Gainesville, Florida, USA.
Duff
Patrick
P
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
D001786:Blood Glucose; D005905:Glyburide