What is the role of glyburide for the management of gestational diabetes mellitus (GDM)?

Updated: Apr 29, 2020
  • Author: Thomas R Moore, MD; Chief Editor: George T Griffing, MD  more...
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Answer

Answer

The efficacy and safety of insulin have made it the standard for treatment of diabetes during pregnancy. Nevertheless, the oral agents glyburide and metformin are gaining popularity. Trials have shown these agents to be effective and no evidence of harm to the fetus has been found, although the potential for long-term adverse effects remains a concern. [8]

Glyburide is a second-generation sulfonyurea that is minimally transported across the human placenta. This is probably largely due to the high plasma protein binding coupled with a short half-life. [82, 83] In addition, a human placenta perfusion study demonstrated active glyburide transport from the fetus to the mother. [84]


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