Med Student Medical News about Pregnancy in Diabetics Glyburide

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Can pregnant diabetics be treated with glyburide?
Women's Health, 11/02/09

Melamed N et al. – Until the last decade, oral hypoglycemic agents have not been recommended in pregnancy owing to fear of their potential adverse fetal effects, including teratogenicity and neonatal hypoglycemia. However, the evidence in support of these recommendations is weak and is principally based on case series involving the use of first–generation sulfonylureas. Studies using a single–cotyledon placental model have found glyburide to only minimally cross the placenta, an observation that paved the way for a landmark randomized clinical trial that found glyburide to be as safe and effective as insulin in the management of gestational diabetes mellitus. Still, contradicting results regarding its trans–placental transfer, lack of adequate data regarding its safety during the first trimester and reports of increased neonatal morbidity raise concerns regarding the universal application of glyburide as an alternative to insulin therapy in diabetic pregnant women.