Re: Glyburide

From: Elrod Darryl G MAJ 48 MDOS/SGOBO (Darryl.elrod@LAKENHEATH.AF.MIL)
Wed Mar 23 13:23:38 2005


Lynn,

Do you test them as you would an A2 on insulin? Do you still recommend delivery at or about 39 weeks?

Thanks,

Glen

________________________________

From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of Lynn

--
________________________________
D. Montgomery, M.D.
Sent: Wednesday, March 23, 2005 5:47 PM
To: Multiple recipients of list OB-GYN-L
Subject: Glyburide

I have been using it for several years. The South Africans have been using the oral hypoglycemics for many years and have good data on them. In this country, Langer, et al, who was in San Antonio and now New York, did great work using a placental model and demonstrated its relative safety.

I start out with 5 mg per day and increase to a max of 20 mg per day, then if further control is needed, change over to insulin. There is at least one paper recently where they added insulin to the Glyburide. I haven't done that.

Interesting note on a couple of papers at the Society meeting last month that addressed Glyburide therapy was that there seemed to be an increased incidence of patients using Glyburide therapy developing preeclampsia late in pregnancy. Obviously small studies and difficult to sort through the issue that this subset of patients may be at increased risk of developing preeclampsia. The standard line fits: This needs to be looked at in a larger population.

Lynn

Lynn D. Montgomery, M.D.

Maternal-Fetal Medicine, OB/GYN

Rocky Mountain Women's Health

2835 Fort Missoula Rd., Suite 304

Missoula, Montana, 59804

406-549-0978

fax 406-549-0987

e-mail: apgar10@montanadsl.net





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