[Treatment of gestational diabetes with oral hypoglycemic agents]

Aim: To study the accuracy of an oral therapy for gestational diabetes (GD) and literature review.

Patients and methods: Glibenclamide (Daonil) was prescribed in pregnant women with GD diagnosed by O'Sullivan test and hyperglycemic tolerance test. Capillary glycemic control follow up was performed to check the accuracy of the oral treatment all along the pregnancy.

Results: Thirty-seven pregnant women have been involved at an average of 26.7 weeks of amenorrhea. Five of them had a non insulin dependent diabetes mellitus previously diagnosed. The glycemic control was obtained in 64.8 % and two women required metformin in addition. Hypoglycaemia has been noticed in 17 % of cases. In 18.9 %, macrosomia (birth weight upper than 4000 g) was reported. We carried out a cesarean section in 31.8 %. A short hypoglycaemic episode was observed in 10.8 % of new born babies.

Conclusion: Oral therapy for GD is more and more often used and demonstrates an efficacy around 80 % and safety similar as insulin therapy. Our experience showed glibenclamide was useful in two third of cases and easier than insulin in clinical practice.