Carrie J Kremer1, Patrick Duff. 1. Department of Obstetrics and Gynecology, University of Florida College of Medicine, Gainesville, Florida, USA.
Abstract
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.
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.
Authors: Diana L Shuster; Laura M Shireman; Xiaosu Ma; Danny D Shen; Shannon K Flood Nichols; Mahmoud S Ahmed; Shannon Clark; Steve Caritis; Raman Venkataramanan; David M Haas; Sara K Quinney; Laura S Haneline; Alan T Tita; Tracy A Manuck; Kenneth E Thummel; Linda Morris Brown; Zhaoxia Ren; Zane Brown; Thomas R Easterling; Mary F Hebert Journal: Clin Pharmacol Ther Date: 2020-01-25 Impact factor: 6.875
Authors: M F Hebert; X Ma; S B Naraharisetti; K M Krudys; J G Umans; G D V Hankins; S N Caritis; M Miodovnik; D R Mattison; J D Unadkat; E J Kelly; D Blough; C Cobelli; M S Ahmed; W R Snodgrass; D B Carr; T R Easterling; P Vicini Journal: Clin Pharmacol Ther Date: 2009-03-18 Impact factor: 6.903