EFFECTS OF PREGNANCY ON THE PHARMACOKINETICS AND PHARMACODYNAMICS OF GLYBURIDE

这个子项目是利用由NIH/NCRR资助的中心拨款提供的资源的许多研究子项目之一。子项目和调查员(PI)可能从另一个NIH来源获得了主要资金，因此可能会出现在其他CRISE条目中。列出的机构是针对中心的，而不一定是针对调查员的机构。妊娠期糖尿病是妊娠期最常见的糖尿病类型，在美国约有4%的妊娠合并糖尿病。严格的血糖控制和胰岛素可以降低母亲和他们的婴儿的风险，但可能与母亲显著的低血糖有关。妊娠期糖尿病的诊断和治疗存在争议。与妊娠期糖尿病相关的高血糖的治疗传统上是用胰岛素治疗，饮食治疗无效。胰岛素治疗的患者教育和患者接受每天多次注射胰岛素带来的挑战通常会导致缺乏依从性，从而导致血糖控制不佳。最近的一项研究报告，与胰岛素相比，格列本脲治疗妊娠期糖尿病在血糖、大婴儿(与分娩相关的伤害)和新生儿低血糖方面产生了类似的改善，同时降低了母亲的低血糖。了解妊娠期口服降糖药的药代动力学和药效学变化很重要，因为实现血糖控制的机会很少。被诊断患有妊娠期糖尿病并服用稳定剂量格列本脲的孕妇将在怀孕28-38周期间进行研究。血液和尿液将在整个学习日进行采集。如果可能，在分娩和分娩期间将采集更多的血液样本，以测量格列本脲的浓度。

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.