Glyburide Versus Insulin for the Treatment of Women with Gestational Diabetes in Kaiser Permanente Northern California

We aim to compare the effectiveness and safety of glyburide and insulin at improving neonatal and maternal outcomes among women with gestational diabetes mellitus (GDM) requiring medication therapy in Kaiser Permanente Northern California from 2007 to 2016. We will use a cohort study design including women with GDM diagnosed from 2007 to 2016 where treatment groups contrasted are defined by therapy regimens (i.e., insulin versus glyburide or early versus late initiation of glyburide). This project will overcome shortcomings of past studies conducted in this area by using modern statistical methods that allow us to take advantage of variation in treatment patterns after the implementation of the universal Perinatal Center referral policy in 2007. More specifically, our approach consists of a cohort study with time-varying exposure to insulin and glyburide during pregnancy.

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