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Predicting Failure of Glyburide Therapy in Gestational Diabetes
OBJECTIVE: We sought to develop a prediction model to identify women with gestational diabetes (GDM) who require insulin to achieve glycemic control. STUDY DESIGN: Retrospective cohort of all singletons with GDM treated with glyburide 2007–2013. Glyburide failure was defined as reaching glyburide 20...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
2016
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4844846/ https://www.ncbi.nlm.nih.gov/pubmed/26796130 http://dx.doi.org/10.1038/jp.2015.216 |
Sumario: | OBJECTIVE: We sought to develop a prediction model to identify women with gestational diabetes (GDM) who require insulin to achieve glycemic control. STUDY DESIGN: Retrospective cohort of all singletons with GDM treated with glyburide 2007–2013. Glyburide failure was defined as reaching glyburide 20 mg/day and receiving insulin. Glyburide success was defined as any glyburide dose without insulin and >70% of visits with glycemic control. Multivariable logistic regression analysis was performed to create a prediction model. RESULTS: Of 360 women, 63 (17.5%) qualified as glyburide failure and 157 (43.6%) glyburide success. The final prediction model for glyburide failure included prior GDM, GDM diagnosis ≤26 weeks, 1-hour GCT ≥228 mg/dL, 3-hour GTT 1-hour value ≥221 mg/dL, ≥7 post-prandial blood sugars >120 mg/dL in the week glyburide started, and ≥1 blood sugar >200 mg/dL. The model accurately classified 81% of subjects. CONCLUSIONS: Women with GDM who will require insulin can be identified at initiation of pharmacologic therapy. |
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