Hypoglycemia in Glyburide-Treated Gestational Diabetes: Is It Dose-Dependent?

Brustman, Lois; Langer, Oded; Scarpelli, Sophia; Daouk, Manal El; Fuchs, Anna; Rosenn, Barak

doi:10.1097/aog.0b013e3182251ad6

Cited by 5 publications

(5 citation statements)

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“…Multiple studies evaluating the use of glyburide in the treatment of GDM have shown that the vast majority of patients will require less than 10 mg per day for good glycemic control with one study reporting that 80% of patients required less than 5 mg per day. [16][17][18] The maternal elimination half-life of glyburide is quoted to be between 5 and 26 hours with most references reporting 7-10 hours. 19 In our study, the mean time between last dose and sampling was 13.3 hours, primarily as a result of the fact that the majority of our patients were on a once-a-day dosing schedule.…”

Section: Discussionmentioning

confidence: 99%

Glyburide Transport Across the Human Placenta

Schwartz

Rosenn

Aleksa³

et al. 2015

Obstetrics &Amp; Gynecology

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Section: Discussionmentioning

confidence: 99%

Glyburide Transport Across the Human Placenta

Schwartz

Rosenn

Aleksa³

et al. 2015

Obstetrics &Amp; Gynecology

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“…These findings are similar to previous literature reported by Brustman et al that demonstrated a 33% incidence of at least one episode of hypoglycemia in glyburide-treated patients. 16 In that study, incremental increases in glyburide dosing did not raise the incidence of maternal hypoglycemic episodes in pregnancy. Our study goes further by showing no statistically significant difference in maternal hypoglycemic events between the 2.5 mg/day and 5 mg/day starting dose of glyburide.…”

Section: Commentmentioning

confidence: 94%

381: Examining the starting dose of glyburide in gestational diabetes

Glover

Tita

Biggio

2014

American Journal of Obstetrics and Gynecology

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“…Despite the glucose levels, some earlier studies report more adverse outcomes in women treated with glyburide compared to insulin (191,192). More recent studies have shown glyburide to be a safe alternative with no dose-related increment in neonatal hypoglycemia (193).…”

Section: Pharmacological Therapymentioning

confidence: 99%

Diabetes and Pregnancy

Thompson¹,

Berger²,

Feig³

et al. 2013

Canadian Journal of Diabetes

242

143

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All women with pre-existing type 1 or type 2 diabetes should receive preconception care to optimize glycemic control, assess complications, review medications and begin folate supplementation. Care by an interdisciplinary diabetes healthcare team composed of diabetes nurse educators, dietitians, obstetricians and diabetologists, both prior to conception and during pregnancy, has been shown to minimize maternal and fetal risks in women with pre-existing type 1 or type 2 diabetes. Gestational Diabetes MellitusThe diagnostic criteria for gestational diabetes mellitus (GDM) remain controversial; however, the committee has chosen a preferred approach and an alternate approach. The preferred approach is to begin with a 50 g glucose challenge test and, if appropriate, proceed with a 75 g oral glucose tolerance test, making the diagnosis of GDM if !1 value is abnormal (fasting !5.3 mmol/L, 1 hour !10.6 mmol/L, 2 hours !9.0 mmol/L). The alternate approach is a 1-step approach of a 75 g oral glucose tolerance test, making the diagnosis of GDM if !1 value is abnormal (fasting !5.1 mmol/L, 1 hour !10.0 mmol/L, 2 hours !8.5 mmol/L). Untreated GDM leads to increased maternal and perinatal morbidity, while treatment is associated with outcomes similar to control populations. Preconception carePreconception care for women with pregestational diabetes is associated with better outcomes (10,11). Although multidisciplinary clinics improve outcomes, <50% of women receive such care. Women who are heavier, younger and smokers, and who have a lower socioeconomic status, lower health literacy and a poor relationship with their healthcare provider, are less likely to receive preconception care (11e14). Some, but not all, have shown that women with type 2 diabetes are also less likely to receive preconception care (7,15). Higher glycated hemoglobin (A1C) levels are associated with poorer outcomes, but even women who achieve tight glycemic control (A1C <7.0%) have an increased risk of complications, which may be caused, in part, by maternal obesity (16,17). By discussing pregnancy prior to conception, healthcare providers may be able to improve outcomes by educating women Contents lists available at SciVerse ScienceDirect Canadian Journal of Diabetes j o u r n a l h o m e p a g e : w w w . c a n a d ia n j o u r n a l o f d i a b e t e s . c o m

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Hypoglycemia in Glyburide-Treated Gestational Diabetes: Is It Dose-Dependent?

Cited by 5 publications

References 3 publications

Glyburide Transport Across the Human Placenta

Glyburide Transport Across the Human Placenta

381: Examining the starting dose of glyburide in gestational diabetes

Diabetes and Pregnancy

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