INS and gestational diabetes: Historically, both insulin and the oral hypoglycemic agent glyburide were recommended for the treatment of GDM.5 Since oral agents such as glyburide have several advantages over insulin for the treatment of GDM, including greater ease of use, greater acceptance among patients, and lower cost,6 glyburide became widely used for treatment of GDM in the United States in the early 2000s.7 However, more recently controversy has arisen as to the safety and efficacy of glyburide for the treatment of GDM.