The addition of glyburide as an oral medication may improve the outcome of gestational diabetes in women who struggle with insulin dosing….
In the past, clinicians were apprehensive about using glyburide in pregnant women due to potential teratogenic effects. However in the past few years, the use of glyburide to treat gestational diabetes has become more frequent. Tempe A et al. conducted a prospective comparative study assessing the efficacy of glyburide to insulin in the treatment of gestational diabetes.
The study was conducted over 1 year in an Indian population from the Department of Obstetrics and Gynecology of a teaching hospital. Over the course of the study, 64 gestational diabetics were analyzed, of whom 32 received insulin as the control and 32 received glyburide as the study group. The inclusion criteria for study subjects consisted of: gestational diabetes not responding to diet control; a single pregnancy; normal liver and kidney function tests, patients not taking any other oral anti-diabetic drugs and patients with regular antenatal clinic visits. Primary outcome was assessed in terms of achievement of glycemic control determined by calculation of the mean plasma glucose level. Secondary outcomes were assessed by the presence of maternal and fetal complications.
Tempe et al. reported that 93.8% and 97.1% of patients in the glyburide and insulin treated groups, respectively, obtained glycemic control. The mean plasma glucose levels were 90 mg/dL and 92 mg/dL in the glyburide and insulin groups, respectively. The authors reported no significant difference between treatment groups regarding the primary outcome. However, 2 patients receiving glyburide failed to achieve glycemic control and required insulin. The authors reported no significant difference was seen in the incidence of fetal and maternal complications from either of group.
Researchers concluded, "It is possible to comment that glyburide is a safe and non-invasive alternative to insulin injections for the treatment of diabetes in pregnancy, as found in our study. The availability of an oral alterative (glyburide) to insulin for the treatment of pregnant diabetic women is a welcome development; however, randomized controlled studies in large numbers are required to establish its further safety in pregnant women or for its use in the first trimester."
Tempe, A. and Mayanglambam, R. D. (2013), Glyburide as treatment option for gestational diabetes mellitus. Journal of Obstetrics and Gynaecology Research, 39: 1147–1152. doi: 10.1111/jog.12042