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. STUDY
DESIGN: 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%).
CONCLUSION: 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.