EFFECTS OF PREGNANCY ON THE PHARMACOKINETICS AND PHARMACODYNAMICS OF GLYBURIDE

该子项目是利用NIH/NCRR资助的中心赠款提供的资源的许多研究子项目之一。子项目和研究者（PI）可能从另一个NIH来源获得了主要资金，因此可以在其他CRISP条目中表示。所列机构为中心，不一定是研究者所在机构。妊娠糖尿病是妊娠期最常见的糖尿病类型，在美国约占所有妊娠的4%。用胰岛素严格控制血糖可降低母亲及其婴儿的风险，但可能与显著的母亲低血糖有关。妊娠期糖尿病的诊断和治疗是有争议的。与饮食治疗无反应的妊娠糖尿病相关的高血糖症的治疗通常是胰岛素。胰岛素治疗的患者教育和患者接受每日多次胰岛素注射的挑战通常导致缺乏依从性，从而导致血糖控制不良。最近的一项研究报告称，与胰岛素相比，格列本脲治疗妊娠期糖尿病在血糖、大婴儿（相关产伤）和新生儿低血糖方面的改善相似，同时降低了母体低血糖。了解妊娠期间口服降糖药的药代动力学和药效学变化是重要的，因为实现血糖控制的机会窗口很窄。将在妊娠28-38周期间对诊断为妊娠期糖尿病并服用稳定剂量格列本脲的孕妇进行研究。将在整个研究日采集血液和尿液。如果可能，将在分娩和分娩期间采集额外的血液样本，用于测量格列本脲浓度。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Gestational diabetes is the most common type of diabetes in pregnancy, complicating approximately 4% of all pregnancies in the United States. Tight glucose control with insulin reduces risks for the mothers and their babies, but can be associated with significant maternal hypoglycemia. The diagnosis and treatment of gestational diabetes is controversial. Treatment of hyperglycemia associated with gestational diabetes which has not responded to dietary treatment has conventionally been insulin. Challenges posed with patient education for insulin therapy, and patient acceptance with multiple insulin injections daily, often leads to lack of adherence that results in poor glycemic control. A recent study has reported that glyburide as compared to insulin for gestational diabetes resulted in similar improvements in blood glucose, large infants (associated birth injuries) and neonatal low blood sugar, with a decrease in maternal low blood sugar. Understanding the pharmacokinetic and pharmacodynamic changes of oral hypoglycemics during pregnancy is important because there is a narrow window of opportunity to achieve glycemic control. Pregnant women diagnosed with gestational diabetes and on a steady dose of glyburide will be studied between 28-38 weeks gestation. Blood and urine will be collected throughout the study day. If possible, additional blood samples will be collected during labor and delivery for measurement of glyburide concentration.