A comparative study of using glibenclamide versus insulin in the treatment of gestational diabetes mellitus and its outcome

P. S. Rao, Sujata Datta, S. Prajwal


Background: Gestational diabetes mellitus(GDM) is defined as carbohydrate intolerance of variable severity with onset or first recognition during pregnancy. This study aims at determining the efficacy of the glibenclamide versus insulin in achieving the adequate glycemic control and to analyze the maternal and fetal outcomes and to determine the failure rate of glibenclamide, patient compliance and overall cost of the treatment

Methods: This study was carried out for a period of 22 months at Command Hospital Air Force, Bangalore in Dept. of OBG. Women with GDM whose glycemic control was not achieved with medical nutrition therapy with fasting blood sugar (FBS) values >105mg/dl and 2hour post prandial blood sugar (PP) value >140mg/dl were selected and randomized for treatment either glibenclamide or insulin (50 in each group).

Results: The age of the patients in this study ranged from 23 to 33 years. The mean age in glibenclamide group was 27.32 (SD ± 2.84) where as in insulin group was 26.30 (SD ± 3.01). The mean plasma glucose level achieved with glibenclamide was fasting -87.62 mg/dl, post prandial -116.44 mg/dl, before lunch - 95.62mg/dl, after lunch -115.80 mg/dl, before dinner-91.96 mg/dl, after dinner - 116.64 mg/dl, 3AM - 84.42 mg/dl and next day fasting - 86.30mg/dl in comparison with insulin where fasting- 85.54 mg/dl , post prandial -114.14 mg/dl, before lunch - 87.08, after lunch -112.82 mg/dl, before dinner-86.76 mg/dl and after dinner - 114.18 mg/dl, 3AM - 81.16 mg/dl and next day fasting was 86.72mg/dl which is statistically significant. The incidence of maternal and neonatal morbidities was comparable in both the group. 4 % percent of patient treated with glibenclamide had treatment failure. The cost of the treatment and compliance was better with glibenclamide.

Conclusions: It has been concluded that glibenclamide is effective as insulin in achieving adequate glycemic control with no significant maternal and fetal morbidity and mortality.


Cost and compliance, Efficacy, Gestational diabetes mellitus, Glibenclamide, Insulin

Full Text:



Committee on Obstetric practice. Committee opinion no.504: screening and diagnosis of gestational diabetes mellitus. Obstet Gyncol. 2011;118(3):751-3.

American diabetic association gestational diabetes mellitus. Diabetes carev. 2004;27:S88-S90.

Langer O, Conway DL, Berkus MD, Xenakis EM, Gonzales O. A comparison of glyburide and insulin in women with gestational diabetes mellitus. Engl J Med. 2000;343:1134-8.

Goetzl L, Wilkins I. Glyburide compared to insulin for the treatment of gestational diabetes mellitus: a cost analysis J Perinatolog. 2002;22:403-6.

Anjalakshi, Balaji V, Seshiah V. A prospective study comparing insulin and glibenclamide in Asian Indian women. Diab Res Clini Prac.2007;76:474.

Partha M, Sankar BT, Amit K, Saha DP, Noori K. Oral hypoglycemic glibenclamide: can it be a substitute to insulin in the management of gestational diabetes mellitus? a comparative study. J South Asian Feder Obstet Gynecol. 2012;4:28.

Temple A, Mayanglambam RD. Glibenclamide as treatment option for gestational diabetes mellitus. J Obstet Gynaecol Res. 2013;1147-52.

Kalra P, Kachhwaha CP, Singh HV. Prevalence, of gestational diabetes mellitus and its outcome in western Rajasthan. Indian J Endocrinol Meta. 2013;17(4):677.

Conway DL, Gonzales O, Skiver D.Use of glyburide for the treatment of gestational diabetes: the San Aatonio experience. J Maternal Fetal Neonatal Med. 2004;15:515.

Kremer CJ. Glyburide for the treatment of gestational diabetes. Obstet Gynecol. 2004;190(5):1438.

Chmait R, Dinise T, Moore T. Prospective observational study to establish predictors of glyburide success in women with gestational diabetes mellitus. J Perinaatol. 2004;24:617-22.

Jacobson GF, Ramos GA, Ching JY, Kirby RS, Ferrara A, Field R. Comparison of glyburide and insulin for the management of gestational diabetes in large managed care organization. Am J Obstet Gynecol. 2005;193:118-24.

Romero Gutierrez G, Alvarez Cisneros JA, Ponce Ponce de Leon AL. [ Association between insulin resistance and pregnancy induced hypertension a case control study. Ginecol Obstet Mex. 2003;71:244-52.

Chatzi L, Plana E Metabolic syndrome in early pregnancy and risk of preterm birth. Am journal Epidemiol. 2009;170 (7): 829-36.

Monteiro G, Subbalakshmi NK, Pai SR. A study on clinical characteristics of gestational diabetes mellitus associated with intrauterine foetal death. Int J Biomed Res. 2014;5(1):28-30.

Ostlund I, Hanson U, Bjorlund A, Eva N, Norlander E., and al. maternal and fetal outcomes if impaired glucose intolerance is not treated. Diabetes Care. 2003;26:2107-11.

Crowther CA, Hiller JE, Moss JR. Effect of treatment of gestational diabetes mellitus on pregnancy outcomes. N Eng J Med. 2005;352:2477-86.

Landon MB, Gabbe SG, Piana R, Mennuti MT, Main EK. Neonatal morbidity in pregnancy complicated by diabetes mellitus: predictive value of maternal glycaemic profiles. Am J Obstet Gynaecol. 1987;156(5):1089-95.