October 2, 1999
Family Planning, Medications: Pills for Diabetes
Question from Canada:
I’m a type 2 diabetic and currently taking an oral medication (glyburide) to control my sugar levels which are in excellent control. I’ve just discovered that I’m 2 weeks pregnant (unplanned night of passion, of course) and I have read and researched that major birth defects on a developing fetus can be very harmful within the 1st month of pregnancy while on oral medications. I do know that a type 2 diabetic woman should pre-plan a pregnancy and at least start injecting insulin 6 months prior to getting pregnant and remain taking the injections throughout the entire pregnancy. I’m very scared that the oral medication that I’m on have probably already done major harm to the fetus, and if it hasn’t, by switching to insulin this early on in the pregnancy would that still harm the fetus?
There is recent data suggesting that glyburide crosses the placenta in very small amounts and thus represents a low risk to the fetus. If you are planning on continuing the pregnancy, I would suggest that you switch over to insulin ASAP. Over the course of the pregnancy you will have several ultrasound examinations to evaluate the fetus for possible anomalies.