[Treatment of gestational diabetes with oral hypoglycemic agents].
OBJECTIVE
To study the accuracy of an oral therapy for gestational diabetes (GD) and literature review.


METHODS
Glibenclamide (Daonil) was prescribed in pregnant women with GD diagnosed by O'Sullivan test and hyperglycemic tolerance test. Capillary glycemic control follow up was performed to check the accuracy of the oral treatment all along the pregnancy.


RESULTS
Thirty-seven pregnant women have been involved at an average of 26.7 weeks of amenorrhea. Five of them had a non insulin dependent diabetes mellitus previously diagnosed. The glycemic control was obtained in 64.8 % and two women required metformin in addition. Hypoglycaemia has been noticed in 17 % of cases. In 18.9 %, macrosomia (birth weight upper than 4000 g) was reported. We carried out a cesarean section in 31.8 %. A short hypoglycaemic episode was observed in 10.8 % of new born babies.


CONCLUSIONS
Oral therapy for GD is more and more often used and demonstrates an efficacy around 80 % and safety similar as insulin therapy. Our experience showed glibenclamide was useful in two third of cases and easier than insulin in clinical practice.
Carles
G
G
Service de gynécologie obstétrique, centre hospitalier Franck-Joly, avenue de Gaulle, 97320 Saint-Laurent du Maroni, Guyane française. gabriel.carles@wanadoo.fr
Germain
L
L
Alassas
N
N
El Guindi
W
W
Dallah
F
F
Daigre
J-L
JL
D016640:Diabetes, Gestational / Q000188:drug therapy*; D005260:Female; D005320:Fetal Macrosomia / Q000453:epidemiology; D005951:Glucose Tolerance Test; D005905:Glyburide / Q000627:therapeutic use; D006801:Humans; D007003:Hypoglycemia / Q000453:epidemiology; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007328:Insulin / Q000627:therapeutic use; D011247:Pregnancy; D016896:Treatment Outcome
D007004:Hypoglycemic Agents; D007328:Insulin; D005905:Glyburide