A cautionary response to SMFM statement: pharmacological treatment of gestational diabetes
Use of oral agents to treat gestational diabetes mellitus remains controversial. Recent recommendations from the Society for Maternal-Fetal Medicine assert that metformin may be a safe first-line alternative to insulin for gestational diabetes mellitus treatment and preferable to glyburide. However, several issues should give pause to the widespread adoption of metformin use during pregnancy. Fetal concentrations of metformin are equal to maternal, and metformin can inhibit growth, suppress mitochondrial respiration, have epigenetic modifications on gene expression, mimic fetal nutrient restriction, and alter postnatal glu...
Source: American Journal of Obstetrics and Gynecology - June 27, 2018 Category: OBGYN Authors: Linda A. Barbour, Christina Scifres, Amy M. Valent, Jacob E. Friedman, Thomas Buchanan, Donald Coustan, Kjersti Aagaard, Kent L. Thornburg, Patrick M. Catalano, Henry Galan, William W. Hay, Antonio E. Frias, Kartik Shankar, Rebecca A. Simmons, Robert G. M Tags: Viewpoint Source Type: research
Needle beats pill in gestational diabetes mellitus
Needle beats pill in gestational diabetes mellitus, Published online: 25 June 2018; doi:10.1038/s41574-018-0050-0Given the steady increase in the use of oral antidiabetic medication, better knowledge of their effects on neonatal outcomes in gestational diabetes mellitus is essential. Recently, Marie-Victoire Sénat and colleagues investigated the use of glyburide over standard insulin treatment in a noninferiority multicentre randomized trial, which found higher risk of perinatal complications under glyburide therapy. (Source: Nature Reviews Endocrinology)
Source: Nature Reviews Endocrinology - June 25, 2018 Category: Endocrinology Authors: Alexandra Kautzky-Willer J ürgen Harreiter Source Type: research
Serious hypoglycemia and use of warfarin in combination with sulfonylureas or metformin.
This article is protected by copyright. All rights reserved.
PMID: 29885251 [PubMed - as supplied by publisher] (Source: Clinical Pharmacology and Therapeutics)
Source: Clinical Pharmacology and Therapeutics - June 9, 2018 Category: Drugs & Pharmacology Authors: Nam YH, Brensinger CM, Bilker WB, Leonard CE, Han X, Hennessy S Tags: Clin Pharmacol Ther Source Type: research
Long-Term Outcomes in Patients Aged
Background and Purpose—We aimed to determine whether subjects aged ≤70 years who were treated with intravenous glyburide (RP-1127; BIIB093; glibenclamide) would have better long-term outcomes than those who received placebo.Methods—GAMES-RP (Glyburide Advantage in Malignant Edema and Stroke–Remedy Pharmaceuticals) was a prospective, double-blind, randomized, placebo-controlled phase 2 clinical trial. Eighty-six participants, aged 18 to 80 years, who presented to 18 centers with large hemispheric infarction (baseline diffusion-weighted imaging volumes, 82–300 cm3) randomized within 10 hours of symptom onset were e...
Source: Stroke - May 25, 2018 Category: Neurology Authors: Kevin N. Sheth, Nils H. Petersen, Ken Cheung, Jordan J. Elm, Holly E. Hinson, Bradley J. Molyneaux, Lauren A. Beslow, Gordon K. Sze, J. Marc Simard, W. Taylor Kimberly Tags: Treatment, Ischemic Stroke Original Contributions Source Type: research
NLRP3 Inflammasome Is Involved in Q-VD-OPH Induced Necroptosis Following Cerebral Ischemia-Reperfusion Injury.
In this study, we determined the optimal dose of Q-VD-OPH, which induces necroptosis in rats by the middle cerebral artery occlusion, followed by reperfusion. Furthermore, we report that the NLRP3 inflammasome is involved in necroptosis, with levels of NLRP3 inflammasome proteins as well as inflammatory cytokines, such as IL-1β, being elevated. We also demonstrated that NLRP3 was not only expressed in microglia and vascular endothelial cell, but also in neurons when necroptosis is induced with Q-VD-OPH. Inhibition of NLRP3 by glyburide strongly suppressed the expression of NLRP3 inflammasome proteins and IL-1β, and marke...
Source: Neurochemical Research - May 25, 2018 Category: Neuroscience Authors: Teng X, Chen W, Liu Z, Feng T, Li H, Ding S, Chen Y, Zhang Y, Tang X, Geng D Tags: Neurochem Res Source Type: research
Metformin for the prevention of hypertensive disorders of pregnancy in women with gestational diabetes and obesity: a systematic review and meta-analysis.
CONCLUSIONS: There is a high probability that metformin use is associated with a reduced HDP incidence when compared to other treatments and placebo. The small number of studies included in the analysis, the low quality of evidence and the clinical heterogeneity preclude the generalization of these results to broader populations. Given the clinical importance of this topic and the magnitude of effect observed in this meta-analysis, further prospective trials are urgently needed. This article is protected by copyright. All rights reserved.
PMID: 29749110 [PubMed - as supplied by publisher] (Source: The Ultrasound Re...
Source: The Ultrasound Review of Obstetrics and Gynecology - May 10, 2018 Category: Radiology Authors: Kalafat E, Sukur YE, Abdulkadir, Thilaganathan B, Khalil A Tags: Ultrasound Obstet Gynecol Source Type: research
Insulin vs Glyburide for Gestational Diabetes
In 2017, gestational diabetes occurred in approximately 14% of pregnancies throughout the world, ranging from 9% in Africa to 12.6% in North America to 21% in Southeast Asia. Although there is not yet global agreement regarding diagnostic criteria for gestational diabetes, there is agreement on the complications of this disorder, including an increased risk of cesarean delivery and preeclampsia in mothers, macrosomia with possible birth injury and neonatal hypoglycemia and jaundice in infants, childhood obesity, and type 2 diabetes in both mothers and offspring. Maternal hyperglycemia, in addition to excess lipids and amin...
Source: JAMA - May 1, 2018 Category: General Medicine Source Type: research
Effect of Glyburide vs Subcutaneous Insulin on Perinatal Complications in Gestational Diabetes
This noninferiority randomized clinical trial compares the effects of glyburide vs subcutaneous insulin on macrosomia, neonatal hypoglycemia, and hyperbilirubinemia in infants born to women with gestational diabetes. (Source: JAMA)
Source: JAMA - May 1, 2018 Category: General Medicine Source Type: research
The Burden of Repeat Prescribing Medications after a Related Adverse Drug Event
The use of medications such as glyburide, neuroleptics and benzodiazepines is potentially dangerous in the elderly, as they are linked to adverse drug events such as hypoglycemia and serious falls. We used administrative data from the province of Ontario to determine how often these medications are continued after a patient experiences one of these adverse events. Over a 12-year period, we identified 31,262 patients who had a hospital presentation with hypoglycemia or a fall within three months of starting the previously listed medications. Re-dispensing of these high-risk medications occurred in 55% of patients within six...
Source: Healthcare Quarterly - April 30, 2018 Category: International Medicine & Public Health Source Type: research
[Structure of primary healthcare units for treating persons with diabetes: Cycles I and II of the Brazilian National Program to Improve Access and Quality].
The objective was to describe the necessary structure for treating diabetes patients in the primary healthcare system, as evaluated in Cycles I and II of the Brazilian National Program for the Improvement of Access and Quality (PMAQ) in 2012 and 2014, according to the municipalities' characteristics. A descriptive study was used to assess primary care units whose teams participated in Cycles I and II of the PMAQ in 2012 and 2014. The study used variables from Module I of the external evaluation of the PMAQ that addresses the primary care units' structure. Materials (150kg scale, sphygmomanometer, adult stethoscope, tape me...
Source: Cadernos de Saude Publica - March 29, 2018 Category: International Medicine & Public Health Authors: Neves RG, Duro SMS, Muñiz J, Castro TRP, Facchini LA, Tomasi E Tags: Cad Saude Publica Source Type: research
Treat gestational diabetes with insulin and/or oral antidiabetic agents when lifestyle changes are not effective
AbstractTreatment of gestational diabetes is important to achieve glycaemic control and reduce the risk of fetal and maternal complications. If nutritional therapy and/or physical activity are ineffective, treatment with insulin is usually recommended. Although metformin and glyburide (glibenclamide) are effective oral antidiabetics, their benefits and risks in treatment gestational diabetes should be carefully considered, as both agents cross the placenta and data on their long-term safety in pregnant women and fetuses are lacking. (Source: Drugs and Therapy Perspectives)
Source: Drugs and Therapy Perspectives - March 26, 2018 Category: Drugs & Pharmacology Source Type: research
Prevalence, pathogenesis and management of prediabetes and type 2 diabetes mellitus in patients with polycystic ovary syndrome.
Authors: Lazaridou S, Dinas K, Tziomalos K
Abstract
Polycystic ovary syndrome (PCOS) is the most common endocrinopathy in women of reproductive age. PCOS is not only the leading cause of anovulatory infertility but is also associated with an array of metabolic disorders, among which impaired glucose metabolism has been a topic of intense research. The aim of the present narrative review is to summarize the findings of the studies that have evaluated the prevalence and incidence of prediabetes and type 2 diabetes mellitus (T2DM) in patients with PCOS, to analyze the factors underpinning the association betw...
Source: Hormones - March 10, 2018 Category: Endocrinology Tags: Hormones (Athens) Source Type: research
Potentially Inappropriate Prescribing in Older Adults with Hypertension or Diabetes Mellitus and Hypertension at Primary Care Setting in Bahrain
Conclusions: The prevalence of potentially inappropriate prescribing, 34.1%, was within the spectrum reported world-wide and unrelated to the training backgrounds of physicians. Most of the identified potentially inappropriate prescribing (76.3%) in older adults was associated with medications for acute medical illnesses hence inappropriate polypharmacy should be discouraged. (Source: Medical Principles and Practice)
Source: Medical Principles and Practice - March 2, 2018 Category: Internal Medicine Source Type: research
Impact of oral hypoglycemic agents on mortality among diabetic patients with non-muscle-invasive bladder cancer: A population-based analysis.
CONCLUSIONS: In this large, population-based study, we have provided further evidence that metformin use does not significantly impact DSS among diabetic patients diagnosed with NMIBC. However, our findings demonstrate that glyburide use inversely affects DSS. The detrimental effect of glyburide on DSS will require further validation.
PMID: 29485035 [PubMed - as supplied by publisher] (Source: Canadian Urological Association Journal)
Source: Canadian Urological Association Journal - February 23, 2018 Category: Urology & Nephrology Authors: Richard PO, Ahmad AE, Bashir S, Zlotta A, Bhindi B, Leao R, Nayan M, Mohammed A, Fleshner NE, Kulkarni GS Tags: Can Urol Assoc J Source Type: research
