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Re: new case: pyelo & oligo & A2 DMFrom: Brickster0@aol.comTue Jun 15 05:19:06 2004
In the green journal this year in the "expert" review section they state to use glyburide 2.5mg bid Brick In a message dated 6/14/2004 5:43:09 PM Eastern Standard Time, rmeisel@mac.com writes: She is on an insulin substitute. So I would use the same management scheme as an insulin requiring gestational diabetic. Personally I'd treat and begin the induction when afebrile unless my hand was forced by the fetal status. BTW in view of ACOG and the ADA statements of the past year (which oppose the treatment with oral agents for diabetes) how are listers justifying treatment with these agents. I ask because I'd like to switch without resorting to an IRB'd protocol. ACOG- "At this time, no other oral agent has been shown to be safe and effective in GDM, and this study has not been confirmed. Further study is recommended before the use of newer oral hypoglycemic agents can be supported for use in pregnancy." ADA- "Glyburide is not FDA approved for the treatment of GDM and further studies are needed in a larger patient population to establish its safety." Best wishes, Ric Meisel, MD
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