Glyburide for the treatment of gestational diabetes mellitus.
Journal Title: Pharmacological Reports - Year 2008, Vol 60, Issue 3
Abstract
Insulin is the traditional treatment for gestational diabetes mellitus (GDM) unresponsive to dietary interventions. Until recently, oral hypoglycemic drugs had been contraindicated due to concerns regarding teratogenicity and the possibility of neonatal hypoglycemia. In contrast to other sulfonylurea drugs, in vitro and in vivo investigations have demonstrated very low transplacental transport of glyburide to the fetal circulation. The mechanisms preventing glyburide from crossing the human placenta are not completely understood. A combination of extremely high protein binding and a relatively short elimination half-life might partially explain it. It has also been demonstrated that glyburide is effluxed from the fetal to the maternal circulation by the breast cancer resistance protein (BRCP) and the human multidrug resistance protein 3 (MRP3). Since 2000, several studies have reported an 80-85% success rate of glyburide treatment. However, some authors have noticed glyburide-related increased risk of preeclampsia, macrosomia, neonatal hypoglycemia, admission to a neonatal intensive care unit and need for phototherapy. These possible maternal as well as neonatal adverse outcomes warrant further investigations. Until that time, the use of glyburide should remain inadvisable in pregnancy.
Authors and Affiliations
Zaneta Kimber-Trojnar, Beata Marciniak, Bozena Leszczyńska-Gorzelak, Marcin Trojnar, Jan Oleszczuk
Keywords
Related Articles
- EP ID EP128981
- DOI -
- Views 94
- Downloads 0
Molecular assessment of the potential combination therapy of cytokines with biphalin and AZT for Friend leukemia virus infection in vitro.
Biphalin, a dimeric enkephalin analog, is under investigation as a potential, long-lasting medication of pain associated with chronic diseases, like cancer or AIDS. The role of cytokines, and splenocytes in anti-Friend l...
Potential pitfalls of propofol target controlled infusion delivery related to its pharmacokinetics and pharmacodynamics.
Target controlled infusion (TCI) devices are increasingly used in clinical practice. These devices unquestionably aid optimization of drug dosage. However, it still remains to be determined if they sufficiently address d...
Mechanisms and pharmacology of diabetic neuropathy - experimental and clinical studies.
Neuropathic pain is the most common chronic complication of diabetes mellitus. The mechanisms involved in the development of diabetic neuropathy include changes in the blood vessels that supply the peripheral nerves; met...
Toxicity of pyrimidine derivatives under oxidative stress conditions: chemiluminescence-based assays in systems containing erythrocytes, mitochondria or blood plasma.
Participation of mono-, di-, and tricyclic pyrimidine derivatives in free radical processes was investigated with the use of luminol-enhanced chemiluminescence in measurements performed in vitro in systems containing ery...
Frequency of the C1236T, G2677T/A and C3435T MDR1 gene polymorphisms in the Serbian population.
The multi-drug resistance 1 (MDR1) gene encodes for a P-glycoprotein (PGP), which acts as a gate-keeper against various kinds of xenobiotics. Several single nucleotide polymorphisms (SNPs) in the MDR1 gene that may influ...