The Effect of Body Mass Index on Glyburide Therapy in Pregnancy [26Q

Abstract

INTRODUCTION: To determine association between glycemic control and body mass index (BMI) in women with gestational diabetes mellitus (GDM). METHODS: Retrospective study of women diagnosed with GDM and delivered at a university-affiliated hospital between November 2011 and November 2014. Adequate glycemic control was defined as: Fasting blood glucose less than 95 mg/dL or 1 hour postprandials greater than 140 mg/dL. BMI at delivery was calculated. The primary outcome was glycemic control using blood glucose log closest to the time of delivery. Parametric and non-parametric tests were employed for statistical analyses as appropriate. RESULTS: 171 women met eligibility criteria: 10.5% overweight (n=18), 62.6% obese (n=107) and 24.6% morbidly (n=42). Four women (2.3%) with BMI in the normal range at delivery were not included in the analyses because of the small number. Gestational age at initiation of glyburide was 32 weeks (p=0.51). The glyburide daily dose at delivery was 5 mg for both the overweight and obese groups and 10 mg for the morbidly obese group. Total weight gain was similar in the three groups (p=0.53). There was no difference in glycemic control amongst the BMI groups (p=0.204), using the blood glucose log, however, there was a significant difference in HgbA1c levels (p=0.01). CONCLUSION: Successful treatment of GDM with Glyburide is not affected by BMI, using the blood glucose log as a glycemic control marker. However, HbA1c level was different between the BMI groups. Since HbA1c is a marker for long-term glycemic control, this deserves further study to examine its role in management of GDM amongst obese gravidas.