Glyburide: a safe and effective medication for the treatment of gestational diabetes?

This study investigated if glyburide (Glynase) was safer and more effective than insulin in patients with gestational diabetes.

They found that glyburide was associated with an increased risk of neonatal hypoglycemia (low blood sugar) but was well tolerated overall. 

Gestational diabetes mellitus (GDM) occurs when pregnant women develop glucose intolerance leading to high blood glucose during the pregnancy. This can increase the risk of negative outcomes for both the mother and child.GDM can be treated either with lifestyle modifications (diet, exercise) or using medication. Insulin therapy is the first-line of treatment however not all women respond adequately.

Glyburide is a sulfonylurea which can be taken orally. These types of medications can stimulate cells in the pancreas to produce insulin. Insulin is the hormone needed to break down the glucose taken in from food. The safety and efficacy of glyburide for the treatment of GDM has not been well established. 

This study analyzed the results from clinical trials examining glyburide in GDM treatment. 

This study included data from 10 clinical trials. Patients were receiving either insulin or glyburide treatment for GDM. The effect of these drugs on maternal outcomes (effects on the mother) and neonatal outcomes (effects on the child) were compared.

Mothers receiving glyburide or insulin had similar maternal outcomes including blood sugar management, severe hypoglycemia (low blood sugar), risk of preterm birth and pre-eclampsia. Glyburide was associated with an 89% increased risk of high blood glucose in the baby (neonatal hypoglycemia).

This study concluded that glyburide is a safe and effective medication for the treatment of GDM, however monitoring for neonatal hypoglycemia is essential. 

This study compared data from 10 studies, with varying designs and reporting. No studies addressed the long-term effects of glyburide on the mother or child.

If you have any concerns regarding treatment of GDM, please discuss with your doctor.