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Old 08-22-2013
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Default DM IN PREGNANCY & Conrad fisher

MTB2 page 465 "sulfonylurea use is contraindicated in pregnancy". But same MTB2 page 467" both metformin and glyburide may be both safe and effective" for DM in pregnancy.......

Is glyburide not a sulfonylurea ????

2ndly,can a kind soul pls tell me which is best used;Regular insulin or NPH for DM in pregnancy
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Old 08-22-2013
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If i recall correctly, all OSUs are contraindicated in pregnancy except glyburide. But don't take my word on it as gospel.

Your 2nd question i'm not very sure. But if i had to guess you'd use insulin regimens similar to what you might use for a normal non pregnant diabetic, with long acting insulins in the morning followed by short acting/NPH before meals.
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Old 08-23-2013
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Originally Posted by rohit39 View Post
If i recall correctly, all OSUs are contraindicated in pregnancy except glyburide. But don't take my word on it as gospel.

Your 2nd question i'm not very sure. But if i had to guess you'd use insulin regimens similar to what you might use for a normal non pregnant diabetic, with long acting insulins in the morning followed by short acting/NPH before meals.
In uworld(can't remember question Id) they said regular insulin & very short acting insulin is only allowed in pregnancy.NPH was wrong in that question

But MTB lists NPH as DOC for diabetes in pregnancy and he states that sulphonylurea is contraindicated(pg 465 new edition).Then he gets to page 467 and says that if patient refuses taking insulin, that metformin and glyburide which I believe is a sulphonylurea should be used.

Can someone pls clarify what is used for DM in pregnancy ???
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Old 08-23-2013
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Originally Posted by blade View Post
In uworld(can't remember question Id) they said regular insulin & very short acting insulin is only allowed in pregnancy.NPH was wrong in that question

But MTB lists NPH as DOC for diabetes in pregnancy and he states that sulphonylurea is contraindicated(pg 465 new edition).Then he gets to page 467 and says that if patient refuses taking insulin, that metformin and glyburide which I believe is a sulphonylurea should be used.

Can someone pls clarify what is used for DM in pregnancy ???
Yes, glyburide and metformin are considered reasonably safe in pregnancy, although you give them only if patient rejects insulin treatment. Source Wikipedia

About which insulin is used, I know for a fact that the short acting insulin is definitely used, but not sure about NPH.
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Old 08-23-2013
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Originally Posted by rohit39 View Post
Yes, glyburide and metformin are considered reasonably safe in pregnancy, although you give them only if patient rejects insulin treatment. Source Wikipedia

About which insulin is used, I know for a fact that the short acting insulin is definitely used, but not sure about NPH.
But if UW said NPH is wrong, I'd suggest you follow that!
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