Tags

Type your tag names separated by a space and hit enter

Comparison of glyburide and insulin for the management of gestational diabetics with markedly elevated oral glucose challenge test and fasting hyperglycemia.
J Perinatol 2007; 27(5):262-7JP

Abstract

OBJECTIVE

To compare the effectiveness of glyburide and insulin for the treatment of Gestational diabetes mellitus (GDM) in women who had OGCT >or=200 mg/dl and fasting hyperglycemia.

STUDY DESIGN

A retrospective study was performed among a subset of women treated with glyburide or insulin for GDM from 1999 to 2002 with an OGCT >or=200 mg/dl and pretreatment fasting plasma glucose >or=105 mg/dl. Exclusion criteria included pretreatment fasting >or=140 mg/dl, gestational age >or=34 weeks and multiple gestation. Maternal and neonatal outcomes were assessed. Statistical methods included bivariate and multivariable logistic regression analyses.

RESULTS

In 1999 to 2000, 78 women were treated with insulin; in 2001 to 2002, 44 of 69 (64%) received glyburide. There were no statistically significant differences between the two groups with regards to mean OGCT (230+/-25 vs 223+/-23 mg/dl, P=0.07) and mean pretreatment fasting (120+/-10 vs 119+/-11 mg/dl, P=0.45). Seven women (16%) failed glyburide. Women in the insulin group were younger (31.5+/-5.8 vs 35.2+/-4.7 years, P<0.001) and had a higher mean BMI (32.4+/-6.4 vs 29.1+/-5.8 kg/m(2), P=0.003) compared to glyburide group. There were no significant differences in birth weight (3524+/-548 vs 3420+/-786 g, P=0.65), macrosomia (19 vs 23%, P=0.65), pre-eclampsia (12 vs 11%, P=0.98) or cesarean delivery (39 vs 46%, P=0.45). Neonates in the glyburide group were diagnosed more frequently with hypoglycemia (34 vs 14%, P=0.01). When controlled for confounders, macrosomia was found to be associated with glyburide treatment (OR 3.5, 95% CI 1.1 to 11.4).

CONCLUSION

In women with GDM who had a markedly elevated OGCT and fasting hyperglycemia, glyburide achieved similar birth weights and delivery outcomes but was associated with an increased risk of macrosomia. The possible increased risk of neonatal hypoglycemia in the glyburide group warrants further investigation.

Authors+Show Affiliations

Reproductive Medicine Department, University of California, San Diego, CA 92103-8433, USA. gramos@ucsd.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

17363911

Citation

Ramos, G A., et al. "Comparison of Glyburide and Insulin for the Management of Gestational Diabetics With Markedly Elevated Oral Glucose Challenge Test and Fasting Hyperglycemia." Journal of Perinatology : Official Journal of the California Perinatal Association, vol. 27, no. 5, 2007, pp. 262-7.
Ramos GA, Jacobson GF, Kirby RS, et al. Comparison of glyburide and insulin for the management of gestational diabetics with markedly elevated oral glucose challenge test and fasting hyperglycemia. J Perinatol. 2007;27(5):262-7.
Ramos, G. A., Jacobson, G. F., Kirby, R. S., Ching, J. Y., & Field, D. R. (2007). Comparison of glyburide and insulin for the management of gestational diabetics with markedly elevated oral glucose challenge test and fasting hyperglycemia. Journal of Perinatology : Official Journal of the California Perinatal Association, 27(5), pp. 262-7.
Ramos GA, et al. Comparison of Glyburide and Insulin for the Management of Gestational Diabetics With Markedly Elevated Oral Glucose Challenge Test and Fasting Hyperglycemia. J Perinatol. 2007;27(5):262-7. PubMed PMID: 17363911.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparison of glyburide and insulin for the management of gestational diabetics with markedly elevated oral glucose challenge test and fasting hyperglycemia. AU - Ramos,G A, AU - Jacobson,G F, AU - Kirby,R S, AU - Ching,J Y, AU - Field,D R, Y1 - 2007/03/15/ PY - 2007/3/17/pubmed PY - 2007/8/2/medline PY - 2007/3/17/entrez SP - 262 EP - 7 JF - Journal of perinatology : official journal of the California Perinatal Association JO - J Perinatol VL - 27 IS - 5 N2 - OBJECTIVE: To compare the effectiveness of glyburide and insulin for the treatment of Gestational diabetes mellitus (GDM) in women who had OGCT >or=200 mg/dl and fasting hyperglycemia. STUDY DESIGN: A retrospective study was performed among a subset of women treated with glyburide or insulin for GDM from 1999 to 2002 with an OGCT >or=200 mg/dl and pretreatment fasting plasma glucose >or=105 mg/dl. Exclusion criteria included pretreatment fasting >or=140 mg/dl, gestational age >or=34 weeks and multiple gestation. Maternal and neonatal outcomes were assessed. Statistical methods included bivariate and multivariable logistic regression analyses. RESULTS: In 1999 to 2000, 78 women were treated with insulin; in 2001 to 2002, 44 of 69 (64%) received glyburide. There were no statistically significant differences between the two groups with regards to mean OGCT (230+/-25 vs 223+/-23 mg/dl, P=0.07) and mean pretreatment fasting (120+/-10 vs 119+/-11 mg/dl, P=0.45). Seven women (16%) failed glyburide. Women in the insulin group were younger (31.5+/-5.8 vs 35.2+/-4.7 years, P<0.001) and had a higher mean BMI (32.4+/-6.4 vs 29.1+/-5.8 kg/m(2), P=0.003) compared to glyburide group. There were no significant differences in birth weight (3524+/-548 vs 3420+/-786 g, P=0.65), macrosomia (19 vs 23%, P=0.65), pre-eclampsia (12 vs 11%, P=0.98) or cesarean delivery (39 vs 46%, P=0.45). Neonates in the glyburide group were diagnosed more frequently with hypoglycemia (34 vs 14%, P=0.01). When controlled for confounders, macrosomia was found to be associated with glyburide treatment (OR 3.5, 95% CI 1.1 to 11.4). CONCLUSION: In women with GDM who had a markedly elevated OGCT and fasting hyperglycemia, glyburide achieved similar birth weights and delivery outcomes but was associated with an increased risk of macrosomia. The possible increased risk of neonatal hypoglycemia in the glyburide group warrants further investigation. SN - 0743-8346 UR - https://www.unboundmedicine.com/medline/citation/17363911/Comparison_of_glyburide_and_insulin_for_the_management_of_gestational_diabetics_with_markedly_elevated_oral_glucose_challenge_test_and_fasting_hyperglycemia_ L2 - http://dx.doi.org/10.1038/sj.jp.7211683 DB - PRIME DP - Unbound Medicine ER -