Insulin Pill Offered to Diabetics

Friday, October 20th 2000, 12:00 am
By: News On 6

A pill already on the market can safely substitute for insulin injections in women who develop diabetes during pregnancy, a study found.

The drug, glyburide, is already commonly taken to control diabetes. However, diabetic women on the drug are told to stop taking it when they get pregnant for fear it may cause fetal death or defects.

The new study indicates the drug is safe to take in the last six months of pregnancy to control what is known as gestational diabetes, a temporary form of diabetes that is a common complication of pregnancy.

Doctors predicted that pregnant women will embrace glyburide pills as an alternative to insulin injections.

``If you had to choose three injections a day or two pills, what would you choose?'' said Dr. Oded Langer, an obstetrician at St. Luke's-Roosevelt Hospital in New York. He led the study, published Thursday in The New England Journal of Medicine.

Up to 10 percent of pregnant women suffer from gestational diabetes. It can be controlled with diet and exercise in about half of pregnancies, but the other women normally need insulin.

Untreated, gestational diabetes in mothers is believed to cause excessive growth and other problems in their babies. It raises the risk of diabetes and obesity later in the children's lives.

The researchers at St. Luke's and the University of Texas-San Antonio studied 404 women at clinics in San Antonio. Half took insulin, half took glyburide.

Insulin controlled blood sugar in 88 percent of the mothers who took it. Glyburide worked in nearly as many: 82 percent.

The researchers could detect no glyburide in the fetuses. The children in both groups weighed the same and showed the same blood sugar levels.

The glyburide was not given in the first three months of pregnancy for fear it might cause birth defects. Drugs for gestational diabetes are normally given in the last six months anyway.

Glyburide works by prodding the pancreas to secrete insulin, a hormone that the body uses to turn sugar into energy. In diabetes, the body's ability to make or use insulin is impaired.

Dr. Michael Greene, an obstetrician at Massachusetts General Hospital in Boston, applauded the researchers' work in an accompanying editorial, saying they were ``prudently defying conventional wisdom and showing the way to an alternative treatment for women with gestational diabetes.''

Langer said the drug would be cheaper than insulin, given the cost of needles and syringes.

Doctors are free to treat pregnant mothers with glyburide now. But the drug's manufacturers would need government approval to promote it for such use.