PMID- 19295505
OWN - NLM
STAT- MEDLINE
DCOM- 20090612
LR  - 20240312
IS  - 1532-6535 (Electronic)
IS  - 0009-9236 (Print)
IS  - 0009-9236 (Linking)
VI  - 85
IP  - 6
DP  - 2009 Jun
TI  - Are we optimizing gestational diabetes treatment with glyburide? The 
      pharmacologic basis for better clinical practice.
PG  - 607-14
LID - 10.1038/clpt.2009.5 [doi]
AB  - Glyburide's pharmacokinetics (PK) and pharmacodynamics have not been studied in 
      women with gestational diabetes mellitus (GDM). The objective of this study was 
      to assess steady-state PK of glyburide, as well as insulin sensitivity, beta-cell 
      responsivity, and overall disposition indices after a mixed-meal tolerance test 
      (MMTT) in women with GDM (n = 40), nonpregnant women with type 2 diabetes 
      mellitus (T2DM) (n = 26), and healthy pregnant women (n = 40, MMTT only). At 
      equivalent doses, glyburide plasma concentrations were approximately 50% lower in 
      pregnant women than in nonpregnant subjects. The average umbilical cord/maternal 
      plasma glyburide concentration ratio at the time of delivery was 0.7 +/- 0.4. 
      Insulin sensitivity was approximately fivefold lower in women with GDM as 
      compared with healthy pregnant women. Despite comparable beta-cell responsivity 
      indices, the average beta-cell function corrected for insulin resistance was more 
      than 3.5-fold lower in women with glyburide-treated GDM than in healthy pregnant 
      women. Women with GDM in whom glyburide treatment has failed may benefit from 
      alternative medication or dosage escalation; however, fetal safety should be kept 
      in mind.
FAU - Hebert, M F
AU  - Hebert MF
AD  - Department of Pharmacy, University of Washington, Seattle, Washington, USA. 
      mhebert@u.washington.edu
FAU - Ma, X
AU  - Ma X
FAU - Naraharisetti, S B
AU  - Naraharisetti SB
FAU - Krudys, K M
AU  - Krudys KM
FAU - Umans, J G
AU  - Umans JG
FAU - Hankins, G D V
AU  - Hankins GD
FAU - Caritis, S N
AU  - Caritis SN
FAU - Miodovnik, M
AU  - Miodovnik M
FAU - Mattison, D R
AU  - Mattison DR
FAU - Unadkat, J D
AU  - Unadkat JD
FAU - Kelly, E J
AU  - Kelly EJ
FAU - Blough, D
AU  - Blough D
FAU - Cobelli, C
AU  - Cobelli C
FAU - Ahmed, M S
AU  - Ahmed MS
FAU - Snodgrass, W R
AU  - Snodgrass WR
FAU - Carr, D B
AU  - Carr DB
FAU - Easterling, T R
AU  - Easterling TR
FAU - Vicini, P
AU  - Vicini P
CN  - Obstetric-Fetal Pharmacology Research Unit Network
LA  - eng
GR  - UL1 TR000005/TR/NCATS NIH HHS/United States
GR  - U10 HD047905/HD/NICHD NIH HHS/United States
GR  - UL1 RR025014-02S1/RR/NCRR NIH HHS/United States
GR  - U10 HD047890/HD/NICHD NIH HHS/United States
GR  - M01 RR000037-475428/RR/NCRR NIH HHS/United States
GR  - P41EB001975/EB/NIBIB NIH HHS/United States
GR  - UL1 RR025014/RR/NCRR NIH HHS/United States
GR  - U10HD047905/HD/NICHD NIH HHS/United States
GR  - M01 RR023942/RR/NCRR NIH HHS/United States
GR  - M01RR023942/RR/NCRR NIH HHS/United States
GR  - UL1 TR000423/TR/NCATS NIH HHS/United States
GR  - U10 HD047892/HD/NICHD NIH HHS/United States
GR  - P41 EB001975-09/EB/NIBIB NIH HHS/United States
GR  - U10HD047890/HD/NICHD NIH HHS/United States
GR  - M01RR00037/RR/NCRR NIH HHS/United States
GR  - U10HD047891/HD/NICHD NIH HHS/United States
GR  - U10 HD047905-05/HD/NICHD NIH HHS/United States
GR  - U10 HD047892-04/HD/NICHD NIH HHS/United States
GR  - U10HD047892/HD/NICHD NIH HHS/United States
GR  - M01 RR000037/RR/NCRR NIH HHS/United States
GR  - P41 EB001975/EB/NIBIB NIH HHS/United States
GR  - U10 HD047891-05/HD/NICHD NIH HHS/United States
GR  - U10 HD047891/HD/NICHD NIH HHS/United States
GR  - M01 RR020359-026170/RR/NCRR NIH HHS/United States
GR  - UL1RR025014/RR/NCRR NIH HHS/United States
GR  - M01 RR023942-016467/RR/NCRR NIH HHS/United States
GR  - M01 RR020359/RR/NCRR NIH HHS/United States
PT  - Clinical Trial
PT  - Comparative Study
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
DEP - 20090318
PL  - United States
TA  - Clin Pharmacol Ther
JT  - Clinical pharmacology and therapeutics
JID - 0372741
RN  - 0 (Blood Glucose)
RN  - 0 (Hypoglycemic Agents)
RN  - EC 1.14.13.- (CYP2C9 protein, human)
RN  - EC 1.14.13.- (Cytochrome P-450 CYP2C9)
RN  - EC 1.14.14.1 (Aryl Hydrocarbon Hydroxylases)
RN  - SX6K58TVWC (Glyburide)
SB  - IM
MH  - Adult
MH  - Area Under Curve
MH  - Aryl Hydrocarbon Hydroxylases
MH  - Blood Glucose/analysis
MH  - Cytochrome P-450 CYP2C9
MH  - Diabetes Mellitus, Type 2/*drug therapy
MH  - Diabetes, Gestational/*drug therapy
MH  - Dose-Response Relationship, Drug
MH  - Female
MH  - Fetal Blood/chemistry
MH  - Glyburide/pharmacokinetics/*therapeutic use
MH  - Humans
MH  - Hypoglycemic Agents/pharmacokinetics/*therapeutic use
MH  - Insulin Resistance
MH  - Insulin-Secreting Cells/drug effects/physiology
MH  - Metabolic Clearance Rate
MH  - Monte Carlo Method
MH  - Pregnancy
MH  - Pregnancy Trimester, Third
PMC - PMC2684566
MID - NIHMS98809
EDAT- 2009/03/20 09:00
MHDA- 2009/06/13 09:00
PMCR- 2010/06/01
CRDT- 2009/03/20 09:00
PHST- 2009/03/20 09:00 [entrez]
PHST- 2009/03/20 09:00 [pubmed]
PHST- 2009/06/13 09:00 [medline]
PHST- 2010/06/01 00:00 [pmc-release]
AID - clpt20095 [pii]
AID - 10.1038/clpt.2009.5 [doi]
PST - ppublish
SO  - Clin Pharmacol Ther. 2009 Jun;85(6):607-14. doi: 10.1038/clpt.2009.5. Epub 2009 
      Mar 18.