Glyburide not effective in preventing complications in gestational diabetes, say researchers

Glyburide is not effective in preventing perinatal complications of gestational diabetes, according to new research.
Glyburide, a sulphonylurea designed to lower blood sugar levels in type 2 diabetes, has been investigated as a pregnancy drug for years, and is recommended as first-line treatment for gestational diabetes patients in the US.
However, recent studies have returned mixed results. One 2015 study claimed glyburide aided blood sugar management in women with gestational diabetes, but another study from that year revealed the drug was linked to birth complications.
This new study conducted by a team of French researchers compared glyburide with subcutaneous insulin in 914 women with gestational diabetes. A total of 460 received glyburide; 454 received insulin.
Three birth complications were considered primary endpoint outcomes: macrosomia (relating to birth weight), hyperbilirubinemia (relating to the onset of jaundice) and neonatal hypoglycemia.
Glyburide failed to show that, when compared to insulin, it reduced the frequency of perinatal complications, with researchers concluding the findings “do not justify the use of glyburide as a first-line treatment”.
Study author Marie-Victoire Senat, MD, PhD, of Hopital Bicetre in France, said: “Although the data do not allow a conclusion that glyburide is not inferior to insulin in the prevention of perinatal complications, the results suggest that the increase in complications may be no more than 10.5% compared with insulin.”
Senat stated that a key reason for its recommendation in the US is that is “more convenient for patients, with greater ease of administration and reduced costs”, compared to other blood glucose-lowering medication, such as insulin.
The researchers added: “In clinical situations in which an oral agent may be necessary, mothers, informed by their physicians, would be appropriate decision makers based on their own weighing of benefits and risks.”
The findings have been published online in Journal of the American Medical Association.

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