Re: Glyburide
From: Garry E. Siegel, M.D. (garrys@mindspring.com)
Wed Mar 23 16:23:44 2005
I have used it a bit, and am converting to this as first line if diet
fails.
Personally, I do start fetal surveillance and deliver by 39, maybe 40
weeks tops.
Garry
At Wed, 23 Mar 2005, Elrod Darryl G MAJ 48 MDOS/SGOBO wrote:
>
>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
>
--
Garry E. Siegel, M.D.
Private Practice
Roswell, GA
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