Document Detail


Can pregnant diabetics be treated with glyburide?
MedLine Citation:
PMID:  19863468     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Until the last decade, oral hypoglycemic agents have not been recommended in pregnancy owing to fear of their potential adverse fetal effects, including teratogenicity and neonatal hypoglycemia. However, the evidence in support of these recommendations is weak and is principally based on case series involving the use of first-generation sulfonylureas. Studies using a single-cotyledon placental model have found glyburide to only minimally cross the placenta, an observation that paved the way for a landmark randomized clinical trial that found glyburide to be as safe and effective as insulin in the management of gestational diabetes mellitus. Still, contradicting results regarding its trans-placental transfer, lack of adequate data regarding its safety during the first trimester and reports of increased neonatal morbidity raise concerns regarding the universal application of glyburide as an alternative to insulin therapy in diabetic pregnant women. Thus, there is a need for large, randomized, controlled trials with adequate power to evaluate the possibility of increased neonatal metabolic complications as well as the long-term outcome of infants born to mothers treated with glyburide and insulin. Unless future studies refute current data regarding the efficacy and safety of glyburide, we believe that, owing to its ease of administration, convenience and low cost, glyburide will become the first line of medical treatment in patients with gestational diabetes mellitus within the next few years.
Authors:
Nir Melamed; Yariv Yogev
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Women's health (London, England)     Volume:  5     ISSN:  1745-5065     ISO Abbreviation:  -     Publication Date:  2009 Nov 
Date Detail:
Created Date:  2009-10-29     Completed Date:  2010-01-11     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101271249     Medline TA:  Womens Health (Lond Engl)     Country:  England    
Other Details:
Languages:  eng     Pagination:  649-58     Citation Subset:  IM    
Affiliation:
Helen Schneider Hospital for Women, Rabin Medical Center, Petach Tikva and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
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MeSH Terms
Descriptor/Qualifier:
Diabetes, Gestational / drug therapy*
Drug Therapy, Combination
Female
Glyburide / administration & dosage,  adverse effects,  therapeutic use*
Humans
Hypoglycemic Agents / administration & dosage,  adverse effects,  therapeutic use*
Insulin / therapeutic use
Maternal-Fetal Exchange
Pregnancy
Prenatal Exposure Delayed Effects
Randomized Controlled Trials as Topic
Risk Factors
Chemical
Reg. No./Substance:
0/Hypoglycemic Agents; 10238-21-8/Glyburide; 11061-68-0/Insulin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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