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Pharmacodynamics of Glyburide, Metformin, and Glyburide/Metformin Combination Therapy in the Treatment of Gestational Diabetes Mellitus.
- Source :
-
Clinical pharmacology and therapeutics [Clin Pharmacol Ther] 2020 Jun; Vol. 107 (6), pp. 1362-1372. Date of Electronic Publication: 2020 Jan 25. - Publication Year :
- 2020
-
Abstract
- In gestational diabetes mellitus (GDM), women are unable to compensate for the increased insulin resistance during pregnancy. Data are limited regarding the pharmacodynamic effects of metformin and glyburide during pregnancy. This study characterized insulin sensitivity (SI), β-cell responsivity, and disposition index (DI) in women with GDM utilizing a mixed-meal tolerance test (MMTT) before and during treatment with glyburide monotherapy (GLY, n = 38), metformin monotherapy (MET, n = 34), or GLY and MET combination therapy (COMBO; n = 36). GLY significantly decreased dynamic β-cell responsivity (31%). MET and COMBO significantly increased SI (121% and 83%, respectively). Whereas GLY, MET, and COMBO improved DI, metformin (MET and COMBO) demonstrated a larger increase in DI (P = 0.05) and a larger decrease in MMTT peak glucose concentrations (P = 0.03) than subjects taking only GLY. Maximizing SI with MET followed by increasing β-cell responsivity with GLY or supplementing with insulin might be a more optimal strategy for GDM management than monotherapy.<br /> (© 2019 The Authors Clinical Pharmacology & Therapeutics © 2019 American Society for Clinical Pharmacology and Therapeutics.)
- Subjects :
- Adolescent
Adult
Blood Glucose drug effects
Drug Therapy, Combination
Female
Glyburide pharmacology
Humans
Hypoglycemic Agents pharmacology
Insulin Resistance
Insulin-Secreting Cells metabolism
Longitudinal Studies
Metformin pharmacology
Pregnancy
Prospective Studies
Young Adult
Diabetes, Gestational drug therapy
Glyburide administration & dosage
Hypoglycemic Agents administration & dosage
Metformin administration & dosage
Subjects
Details
- Language :
- English
- ISSN :
- 1532-6535
- Volume :
- 107
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- Clinical pharmacology and therapeutics
- Publication Type :
- Academic Journal
- Accession number :
- 31869430
- Full Text :
- https://doi.org/10.1002/cpt.1749