title: Retrospective cohort study comparing neonatal outcomes of women treated with glyburide or insulin in gestational diabetes: a 5-year experience in a South Indian teaching hospital.
abstract: OBJECTIVE
  To assess the effectiveness of glyburide in preventing complications of gestational diabetes in neonates as compared to insulin.
  
  
  METHODS
  Information from birth register, maternal and neonatal records were obtained. Five hundred and seventy-seven gestational diabetics with moderate hyperglycemia i.e., with highest fasting plasma glucose value of ≤130 mg/dl and/or highest post-prandial value of ≤250 mg/dl treated with insulin or glyburide were included from a cohort of 769 women needing additional therapy to initial diet therapy during a 5-year period. Thus neonatal outcomes of 303 women treated with insulin and 274 women treated with glyburide were compared.
  
  
  RESULTS
  Baseline plasma glucose levels in the group treated with insulin were higher. The mean birth weight (SD) of the neonates in women treated with insulin was 3021.3 g (604.19) as compared to 3104.6 g (499.35, P = 0.07) in the group treated with glyburide. Neonatal outcomes such as hypoglycemia (4.9%, 3.6%, P = 0.44), hypocalcemia (1.3%, 0.7%, P = 0.48), polycythemia (1.7%, 0.7%, P = 0.31), macrosomia (11.6%, 8.7%, P = 0.26), congenital anomalies (2.1%, 2.3%, P = 0.87), birth trauma (1.4%, 1.2%, P = 0.79) were similar in both groups. Neonates of women treated with insulin were more likely to have hyperbilirubinemia (11.5%, 6.5%, P = 0.03).
  
  
  CONCLUSIONS
  Neonatal outcomes of women treated with glyburide were comparable to those in women treated with insulin. More number of neonates of mothers treated with insulin had hyperbilirubinemia compared to neonates of mothers treated with glyburide (11.5%, 6.5% P = 0.03).
authors.affiliation: Department of Obstetrics and Gynecology, Christian Medical College and Hospital, Vellore, Tamil Nadu, India.
authors.forename: Jiji Elizabeth
authors.initials: JE
authors.lastname: Mathews
authors.forename: Biwas
authors.initials: B
authors.lastname: Biswas
authors.forename: Prasanna
authors.initials: P
authors.lastname: Samuel
authors.forename: Atanu Kumar
authors.initials: AK
authors.lastname: Jana
authors.forename: Jaya Prakash
authors.initials: JP
authors.lastname: Muliyil
authors.forename: Matthews
authors.initials: M
authors.lastname: Mathai
mesh_terms: D000328:Adult; D001724:Birth Weight / Q000187:drug effects; D001786:Blood Glucose / Q000378:metabolism; D016640:Diabetes, Gestational / Q000097:blood / Q000188:drug therapy*; D005260:Female; D005320:Fetal Macrosomia / Q000209:etiology; D005905:Glyburide / Q000009:adverse effects / Q000627:therapeutic use*; D006784:Hospitals, Teaching; D006801:Humans; D006932:Hyperbilirubinemia / Q000139:chemically induced; D006996:Hypocalcemia / Q000139:chemically induced; D007003:Hypoglycemia / Q000139:chemically induced; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007194:India; D007231:Infant, Newborn; D007328:Insulin / Q000009:adverse effects / Q000627:therapeutic use*; D011247:Pregnancy; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007328:Insulin; D005905:Glyburide