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. CONCLUSION: Approximately 80% of patients with gestational diabetes who fail to respond to diet therapy can be treated effectively with glyburide.[1]References
- Glyburide for the treatment of gestational diabetes. Kremer, C.J., Duff, P. Am. J. Obstet. Gynecol. (2004) [Pubmed]
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