The aim of this study is to determine the efficacy of oral treatment with glyburide and
metformin controlling excessive fetal growth in women with gestational diabetes, using
insulin as a ransom on no response to oral treatment .
It is randomized with women who seek care at the Outpatient Diabetes in Pregnancy in our
hospital trial Eligible women between 18 - 45anos diagnosed with gestational diabetes ,
according to the WHO criteria , ratified the public network for prenatal care at the Clinic
for Diabetes and Pregnancy HCPA .
Women with singleton pregnancy and gestational age not exceeding 30 weeks at the time of
enrollment.
Pregnant women with indication for pharmacological treatment will be invited to randomization
to use of oral , glyburide or metformin antidiabetic .
At regular intervals of 2 - 3 weeks fetal growth will be measured with obstetric
ultrasonography , until birth.
The primary outcomes will be :
( 1 ) weight and gestational age at birth and the index of large for gestational age fetuses
( ≥ 90th percentile for gestational age ) ( 2 ) the use of insulin to achieve glycemic
targets according to fetal growth , as an indirect measure of the inefficiency of oral
medications .