@article{af23c62b5e7842d1a53e6cfa59970075,
title = "Pharmacodynamics of Glyburide, Metformin, and Glyburide/Metformin Combination Therapy in the Treatment of Gestational Diabetes Mellitus",
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.",
author = "Shuster, {Diana L.} and Shireman, {Laura M.} and Xiaosu Ma and Shen, {Danny D.} and {Flood Nichols}, {Shannon K.} and Ahmed, {Mahmoud S.} and Shannon Clark and Steve Caritis and Raman Venkataramanan and Haas, {David M.} and Quinney, {Sara K.} and Haneline, {Laura S.} and Tita, {Alan T.} and Manuck, {Tracy A.} and Thummel, {Kenneth E.} and Brown, {Linda Morris} and Zhaoxia Ren and Zane Brown and Easterling, {Thomas R.} and Hebert, {Mary F.}",
note = "Funding Information: This research was supported in part by the Eunice Kennedy Shriver National Institute of Child Health and Human Development grants #U10HD063094, U10HD047892, U10HD097905, U10HD047891, U10HD057753, and the National Institutes of Health (NIH) National Center for Advancing Translational Science through the Clinical and Translational Science Awards Program grants #ULITR000423, TLITR000422, ULITR001108, National Institute of General Medical Sciences R01GM124264, and unrestricted research funds from the University of Washington. The content of this manuscript is solely the responsibility of the authors and does not necessarily represent the official views of the Eunice Kennedy Shriver National Institute of Child Health and Human Development or the National Institute of Health. In addition, the views expressed are those of the author(s) and do not reflect the official policy or position of the US Army Medical Department, Department of the Army, Department of Defense, or the US Government. The investigators have adhered to the policies for protection of human subjects as prescribed in 45 CFR 46. In memoriam, we acknowledge the tremendous contribution of David A. Flockhart, PhD, MD, to the Obstetric-fetal Pharmacology Research Unit Network. We also thank the research coordinators and nurses, including Alisha Bouge, Claudine Hernandez, Karen Hays, Ira Kantrowitz-Gordon, Anna Lemchen, Heather Follen, Holly West, Julie Croxford, Dawn Fisher, Wenchen Zhao, Becky Cypher, and Janie Klank for their hard work in completing this study. Funding Information: This research was supported in part by the Eunice Kennedy Shriver National Institute of Child Health and Human Development grants #U10HD063094, U10HD047892, U10HD097905, U10HD047891, U10HD057753, and the National Institutes of Health (NIH) National Center for Advancing Translational Science through the Clinical and Translational Science Awards Program grants #ULITR000423, TLITR000422, ULITR001108, National Institute of General Medical Sciences R01GM124264, and unrestricted research funds from the University of Washington. The content of this manuscript is solely the responsibility of the authors and does not necessarily represent the official views of the Eunice Kennedy Shriver National Institute of Child Health and Human Development or the National Institute of Health. In addition, the views expressed are those of the author(s) and do not reflect the official policy or position of the US Army Medical Department, Department of the Army, Department of Defense, or the US Government. The investigators have adhered to the policies for protection of human subjects as prescribed in 45 CFR 46. Publisher Copyright: {\textcopyright} 2019 The Authors Clinical Pharmacology & Therapeutics {\textcopyright} 2019 American Society for Clinical Pharmacology and Therapeutics",
year = "2020",
month = jun,
day = "1",
doi = "10.1002/cpt.1749",
language = "English (US)",
volume = "107",
pages = "1362--1372",
journal = "Clinical Pharmacology and Therapeutics",
issn = "0009-9236",
publisher = "Nature Publishing Group",
number = "6",
}