Side effects for glyburide
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Summary
5 papers analyzed
These studies suggest that glyburide can cause severe hypoglycemia, increase risks of neonatal complications, and contribute to fetal overgrowth.
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Beta19 papers analyzed
Side Effects of Glyburide: A Comprehensive Overview
Introduction to Glyburide and Its Use in Gestational Diabetes
Glyburide is a sulfonylurea class medication commonly used to manage blood glucose levels in patients with type 2 diabetes and gestational diabetes mellitus (GDM). While effective in controlling blood sugar, glyburide is associated with several side effects, particularly in pregnant women and their newborns.
Increased Birth Weight and Placental Changes
One significant side effect of glyburide in gestational diabetes is its association with increased birth weight. Research indicates that glyburide treatment in GDM pregnancies leads to higher birth weights compared to diet-treated pregnancies. This is attributed to the increased expression of glucose transporter 1 (GLUT1) in the placental syncytiotrophoblast plasma membranes, which enhances transplacental glucose delivery and contributes to fetal overgrowth.
Hypoglycemia and Delayed Recovery
Severe hypoglycemia is a critical side effect of glyburide, more frequent than with other sulfonylureas like glimepiride. Glyburide has been shown to delay plasma glucose recovery from hypoglycemia by inappropriately stimulating insulin secretion even at low plasma glucose levels. This effect is not observed with glimepiride, which may explain the higher incidence of severe hypoglycemia with glyburide use.
Adverse Neonatal Outcomes
Newborns of mothers treated with glyburide for GDM are at an increased risk of several adverse outcomes compared to those treated with insulin. These include higher rates of neonatal intensive care unit (NICU) admissions, respiratory distress, hypoglycemia, birth injuries, and being large for gestational age. These risks highlight the need for careful consideration when choosing glyburide for managing GDM.
Maternal Side Effects
In addition to neonatal risks, glyburide can cause side effects in pregnant women. Approximately 11% of women treated with glyburide for GDM reported noticeable side effects, although only a small fraction discontinued treatment due to these effects. The most common side effects include gastrointestinal disturbances and hypoglycemia.
Pharmacokinetic Considerations
The dosing regimen for glyburide in pregnancy is often based on studies conducted in men and nonpregnant women, leading to potential issues with both overdosing and underdosing. Adjusting the timing of glyburide administration, such as taking it one hour before a meal, may improve its efficacy and reduce side effects in pregnant women.
Conclusion
While glyburide is effective in managing blood glucose levels in gestational diabetes, it is associated with several significant side effects, including increased birth weight, severe hypoglycemia, and adverse neonatal outcomes. Careful consideration and monitoring are essential when using glyburide, and alternative treatments like insulin may be preferable in some cases. Further research is needed to optimize glyburide dosing and minimize its side effects in pregnancy.
Sources and full results
Most relevant research papers on this topic
6
Glyburide (DiaBeta): a new second-generation hypoglycemic agent.
6
6 Citations
1984
7
Glyburide (DiaBeta): a new second-generation hypoglycemic agent.
7
3 Citations
1984