High-Risk Pregnancy

Glyburide vs. Insulin for GD

My fasting numbers remain high regardless of what I eat/do the day before, so my doctor wants to start me on meds. Both my regular OB and my perinatalogist want to put me on a low dose of glyburide.  I am fine with that and trust them, they both talked with me in length about the safety of the meds, various studies that have been done, etc. 

DH, on the other hand, is a worrier. He doesn't understand why they wouldn't put me on insulin since it doesn't cross the placenta and is more easily regulated.  I told him he needs to speak with my doctors directly, I'm not going to play the middle-man between him, Dr. Google, and my actual doctors.  

Anyway, I guess my question is if any of you had similar concerns and what you decided to do?  I REALLY do not want to do injections. But if it is legitimately safer for the baby to do it that way, I will. It just seems that from speaking with my doctors that the oral meds are perfectly fine, so why add even more stress to my day by having to do injections. 

Any thoughts or experience would be greatly appreciated!  

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Re: Glyburide vs. Insulin for GD

  • I'm a type 1 diabetic and of course I did insulin because pills aren't an option for me. But if i had a choice, I would do glyburide. Both medications lower blood sugar, but also there is more infection risk with insulin because you are injecting. That's something to consider. I know that it's not a big risk, but it is still there. Also if the glyburide doesn't work, you will be put on insulin.

    Also, from my experience as a type 1 on insulin for forever, each insulin is not the same in the fact that you could have some severe lows because the insulin doesn't work as desired for your body. I ended up having problems with Novolog because I would bottom out on it into the 20's. Even if I ate a whole bunch of carbs I would constantly bottom out while pregnant.

    Another medication you can ask about it Metformin. It's not a hypoglycemic and it's pregnancy safe. It helps your body use what it has. I'm also a nurse, but that's just my opinion from when I was pregnant.

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  • I am also on a small dose of glyburide. My ob is well informed and chose it over insulin. I only take it before bed for my fasting number.

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  • I'm also on Glyburide at night. I had the same concerns, but the GD clinic at the university/research based teaching hospital where I got prenatal care recommended I start with Glyburide. They see hundreds of GD women per year and are consistently rated one of the top 3 hospitals in CA. I trusted them and my fasting numbers/baby's growth have been fine.
  • I chose insulin and was initially worried about the shots too. It was stressful the first night but now it's literally NBD. It hurts way less than the finger pricking.
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  • I was given a choice between insulin or pills.  My perinatalogist said that insulin is more effective than pills.  I chose insulin and take launtus once daily. I'm 34w5d and have been on the same does for almost two months and numbers have been great. If you choose insulin I would recommend the flex pen.  
  • I was diagnosed at 14wks currently 17.5 and am on insulin as diet alone didn't control my levels. The shots do not hurt as the needle is super tiny as others mentioned the finger prick is more painful. My endocrinologist said insulin is the preferred choice in managing GD however being on insulin over 20wks will possibly weaken the placenta so I'll just have to be monitored more. So far the insulin is working well and giving me peace of mind that I will have a healthy pregnancy!
  • With my first pregnancy, I only had trouble with my fasting numbers and I was put on glyburide. I just got diagnosed again with this pregnancy and I will probably have to do the same. I much prefer taking a pill, but, if I had trouble controlling more numbers, then I would probably switch over to insulin.
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  • If I was concerned, I would discuss it with my OB.

     

    My Maternal Fetal Medicince (high risk) OBs doesn't use oral meds with their GD patients. They feel that they have a tighter control with insulin only, even if it is a small amount. I have heard plenty of women state that they take one or the other, so I think it is a preference, rather than a safety factor.

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  • Because my GD wasn't under control with diet alone, I was first put on Metformin, and then insulin. I wanted to try Metformin first as it is meant to help your body create and use it's own insulin, and I felt that I would prefer to try and encourage that, but unfortunately it didn't help at all. My fasting numbers were still high despite the top dose of Metformin, and it made me feel awful. It did concern me that oral meds cross the placenta, but I wanted to give my body a chance and was told that trying Metformin first would actually help my body work with insulin better if I had to go on it.

    I am now on insulin (and a lower dose of Metformin) and to be honest, I prefer it already.  I can increase the dose without any fuss if my numbers plateau or rise again, without being concerned about increased dosage to baby, and it really does hurt less than the finger pricks. Getting past the initial mental block of jabbing a needle into your stomach is the hardest part. Once you've done it a few times, it's really not a biggie. And this is from someone who used to HATE any kind of needle. Infertility, BS testing and now insulin has definitely helped with that phobia.

    It also doesn't make me feel like rubbish and so far, it has helped to keep all of my numbers consistently in range, rather than peaking and diving all day. 

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