TY - JOUR
T1 - Treatment of gestational diabetes mellitus
T2 - Glyburide compared to subcutaneous insulin therapy and associated perinatal outcomes
AU - Cheng, Yvonne W.
AU - Chung, Judith H.
AU - Block-Kurbisch, Ingrid
AU - Inturrisi, Maribeth
AU - Caughey, Aaron B.
N1 - Funding Information:
Dr Yvonne Cheng is supported by the UCSF Women’s Reproductive Health Research Career Development Award, NIH, the Eunice Kennedy Shriver National Institute of Child Health and Human Development (K12 HD001262).
PY - 2012/4
Y1 - 2012/4
N2 - Objective.To examine perinatal outcomes in women with gestational diabetes mellitus treated with glyburide compared to insulin injections. Study design.This is a retrospective cohort study of women diagnosed with gestational diabetes mellitus (GDM) who required pharmaceutical therapy and were enrolled in the Sweet Success California Diabetes and Pregnancy Program between 2001 and 2004, a California state-wide program. Women managed with glyburide were compared to women treated with insulin injections. Perinatal outcomes were compared using chi-square test and multivariable logistic regression models; statistical significance was indicated by p < 0.05 and 95% confidence intervals (CI). Results.Among the 10,682 women with GDM who required medical therapy and met study criteria, 2073 (19.4%) received glyburide and 8609 (80.6%) received subcutaneous insulin injections. Compared to insulin therapy and controlling for confounders, oral hypoglycemic treatment was associated with increased risk of birthweight >4000 g (aOR = 1.29; 95% CI [1.031.64]), and admission to the intensive care nursery (aOR = 1.46 [1.072.00]). Conclusion.Neonates born to women with gestational diabetes managed on glyburide, and were more likely to be macrosomic and to be admitted to the intensive care unit compared to those treated with insulin injections. These findings should be examined in a large, prospective trial.
AB - Objective.To examine perinatal outcomes in women with gestational diabetes mellitus treated with glyburide compared to insulin injections. Study design.This is a retrospective cohort study of women diagnosed with gestational diabetes mellitus (GDM) who required pharmaceutical therapy and were enrolled in the Sweet Success California Diabetes and Pregnancy Program between 2001 and 2004, a California state-wide program. Women managed with glyburide were compared to women treated with insulin injections. Perinatal outcomes were compared using chi-square test and multivariable logistic regression models; statistical significance was indicated by p < 0.05 and 95% confidence intervals (CI). Results.Among the 10,682 women with GDM who required medical therapy and met study criteria, 2073 (19.4%) received glyburide and 8609 (80.6%) received subcutaneous insulin injections. Compared to insulin therapy and controlling for confounders, oral hypoglycemic treatment was associated with increased risk of birthweight >4000 g (aOR = 1.29; 95% CI [1.031.64]), and admission to the intensive care nursery (aOR = 1.46 [1.072.00]). Conclusion.Neonates born to women with gestational diabetes managed on glyburide, and were more likely to be macrosomic and to be admitted to the intensive care unit compared to those treated with insulin injections. These findings should be examined in a large, prospective trial.
KW - Gestational diabetes mellitus
KW - perinatal outcomes
KW - treatment
UR - http://www.scopus.com/inward/record.url?scp=84858686535&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84858686535&partnerID=8YFLogxK
U2 - 10.3109/14767058.2011.580402
DO - 10.3109/14767058.2011.580402
M3 - Article
C2 - 21631239
AN - SCOPUS:84858686535
SN - 1476-7058
VL - 25
SP - 379
EP - 384
JO - Journal of Maternal-Fetal and Neonatal Medicine
JF - Journal of Maternal-Fetal and Neonatal Medicine
IS - 4
ER -