OBJECTIVE: To identify factors predicting failure of glyburide treatment in women with gestational diabetes mellitus (GDM). METHODS: A retrospective study of all women with GDM that were treated with glyburide in a single tertiary referral center. Patients were switched from glyburide to insulin if they failed to achieve glycemic goals, and were then classified as glyburide failure. RESULTS: Overall, 124 women with GDM treated with glyburide were included in the study, of which 31 (25%) failed to achieve glycemic control. Women in the failure group were characterized by a higher weight gain during pregnancy, higher rates of GDM on previous pregnancies, and a glucose challenge test (GCT) result. On multivariate logistic regression analysis, a GCT value of >200 mg/dl (OR = 7.1, 95% CI 2.8-27.6) and weight gain ≥ 12 kg (OR = 3.9, 95% CI 1.2-13.0) were the only significant and independent predictors of glyburide failure. Most women who were successfully treated with glyburide required a daily dose of 5 mg or less and the time required to achieve glycemic control in these cases was 12.4 ± 4.9 days (range 5-24 days). Of the women who failed to achieve glycemic control with gluburide, 26/31 were switched to insulin, of them only 12 (46%) achieved desired level of glycemic control. CONCLUSION: Most women with GDM achieved desired level of glycemic control under glyburide treatment.
OBJECTIVE: To identify factors predicting failure of glyburide treatment in women with gestational diabetes mellitus (GDM). METHODS: A retrospective study of all women with GDM that were treated with glyburide in a single tertiary referral center. Patients were switched from glyburide to insulin if they failed to achieve glycemic goals, and were then classified as glyburide failure. RESULTS: Overall, 124 women with GDM treated with glyburide were included in the study, of which 31 (25%) failed to achieve glycemic control. Women in the failure group were characterized by a higher weight gain during pregnancy, higher rates of GDM on previous pregnancies, and a glucose challenge test (GCT) result. On multivariate logistic regression analysis, a GCT value of >200 mg/dl (OR = 7.1, 95% CI 2.8-27.6) and weight gain ≥ 12 kg (OR = 3.9, 95% CI 1.2-13.0) were the only significant and independent predictors of glyburide failure. Most women who were successfully treated with glyburide required a daily dose of 5 mg or less and the time required to achieve glycemic control in these cases was 12.4 ± 4.9 days (range 5-24 days). Of the women who failed to achieve glycemic control with gluburide, 26/31 were switched to insulin, of them only 12 (46%) achieved desired level of glycemic control. CONCLUSION: Most women with GDM achieved desired level of glycemic control under glyburide treatment.
Authors: Rebecca M Reynolds; Fiona C Denison; Ed Juszczak; Jennifer L Bell; Jessica Penneycard; Mark W J Strachan; Robert S Lindsay; Claire I Alexander; Corinne D B Love; Sonia Whyte; Fiona Mackenzie; Ben Stenson; Jane E Norman Journal: BMC Pregnancy Childbirth Date: 2017-09-22 Impact factor: 3.007
Authors: Ian Blumer; Eran Hadar; David R Hadden; Lois Jovanovič; Jorge H Mestman; M Hassan Murad; Yariv Yogev Journal: J Clin Endocrinol Metab Date: 2013-11 Impact factor: 5.958