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The Effectiveness of glyburide Compared to Insulin in the Management of Gestational Diabetes Mellitus: A Systematic Review

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Journal of Diabetes Mellitus 2015年第2期5卷 58-66页

作者： Jephthah O. Odiba Mzwandile A. Mabhala Department of Community Health and Wellbeing University of Chester Riverside Campus Chester UK

Background: Insulin therapy has been the mainstay in managing women with gestational diabetes mellitus (GDM), but some disadvantages of insulin have led to the use of glyburide, which is inexpensive in some countries, to manage GDM. However, there has been debate over its effectiveness, efficacy and safety when compared to insulin for maternal glycaemic control, and some adverse neonatal outcomes in GDM. Method: A systematic review of eight randomised controlled trial (RCT) studies was undertaken to compare glyburide and insulin. Studies involving 849 participants were included in the quantitative analysis. Results: There was no significant difference between glyburide and insulin in maternal fasting (P = 0.09;SMD: 0.13;95% CI: ﹣0.02 to 0.28) and postprandial (P = 0.45;SMD: 0.05;95% CI: ﹣0.09 to 0.19) glycaemic control and glycosylated hae-moglobin (P = 0.35;SMD: 0.08;95% CI: ﹣0.08 to 0.24). When compared with insulin, glyburide had an increase risk ratio (RR) for neonatal hypoglycaemia (P = 0.0002;RR: 2.27;95% CI: 1.47 to 3.51) and large for gestational age babies (P = 0.03;RR: 1.60;95% CI: 1.06 to 2.41). Estimation of standard mean difference shows that neonatal birth weight was significantly higher in subjects receiving glyburide than in the insulin group (P = 0.002;SMD: 0.21;95% CI: 0.08 to 0.35). Conclusions: glyburide was seen to be clinically effective and a safer alternative to insulin for maternal glycaemic control in GDM women. It is affordable, convenient and requires no comprehensive educative training at the time of initiation of therapy. However, its adverse outcomes—neonatal hypogly-caemia, high neonatal birth weight and large for gestational age babies—call for careful monitoring of GDM patients for any need for supplemental insulin.

关键词： Gestational Diabetes Mellitus glyburide Insulin

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Transient diabetes mellitus with ABCC8 variant successfully treated with sulfonylurea:Two case reports and review of literature

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World Journal of Diabetes 2024年第8期15卷 1811-1819页

作者： Ling-Hua Shen Yan Cui Dong-Xia Fu Wei Yang Sheng-Nan Wu Hui-Zhen Wang Hai-Hua Yang Yong-Xing Chen Hai-Yan Wei Department of Endocrinology and Metabolism Henan Key Laboratory of Children's Genetics and Metabolic DiseasesChildren's Hospital Affiliated to Zhengzhou UniversityHenan Children's Hospital Zhengzhou Children's HospitalZhengzhou 450018Henan ProvinceChina

BACKGROUND Transient neonatal diabetes mellitus(TNDM)is a rare form of diabetes mellitus that usually presents within the first 6 mo of *** often enter remission within several months,although relapse can occur later in *** in the ABCC8 gene,which encodes the sulfonylurea receptor 1 of the ATP-sensitive potassium channel in pancreatic beta cells,are associated with TNDM and permanent neonatal *** study describes a novel de novo c.3880C>T heterozygous ABCC8 variant that causes TNDM and can be treated with sulfonylurea *** SUMMARY We retrospectively analyzed 2 Chinese patients with TNDM who were diagnosed,treated,or referred for follow-up between September 2017 and September *** patients were tested for mutations using targeted next-generation *** with neonatal diabetes mellitus caused by a c.3880C>T heterozygous missense variant in the ABCC8 gene have not been reported *** children had an onset of post-infectious diabetic ketoacidosis,which is worth *** a follow-up visit after discontinuing insulin injection,oral glyburide was found to be effective with no adverse *** Early genetic testing of neonatal diabetes mellitus aids in accurate diagnosis and treatment and helps avoid daily insulin injections that may cause pain.

关键词： Neonatal diabetes mellitus ABCC8 Sulfonylurea receptors 1 KATP channels Sulfonylurea glyburide Insulinulin Case report

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The role of membrane potential and calcium kinetic changes in the pathogenesis of vascular hyporeactivity during severe shock

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Chinese Medical Journal 2000年第1期113卷 59-64页

作者：赵克森刘杰金春华 Department of Pathophysiology First Military Medical University Guangzhou 510515 China

OBJECTIVE: To determine the role of membrane potential and intracellular calcium kinetic changes in producing vascular hyporeactivity during severe hemorrhagic shock. METHODS: Rats were subjected to hemorrhagic shock (HS) for 2 hours. The spinotrapezius muscle was prepared for microscopy and the responses of arterioles in the muscle to norepinephrine (NE) were tested. The resting membrane potentials of isolated arterial strips were measured with a microelectrode. Membrane potential and intracellular Ca2+ ([Ca2+]i) changes in isolated arteriolar smooth muscle cells (ASMCs) were determined with fluorescent probes and a confocal microscopy. RESULTS: The arteriolar resting membrane potential was decreased from -36.7 +/- 6.3 mV in control to -29.2 +/- 5.3 mV concurrent with the increase of vasoreactivity to NE at 20 minutes after HS. At 120 minutes post-HS, the resting potential hyperpolarized to -51.9 +/- 9.1 mV, and NE stimulated [Ca2+]i increase was reduced to 50% of the control values during the appearance of arteriolar hyporeactivity, i.e. the NE threshold of the arteriolar response increased 15 fold 2 hours after the onset of hemorrhage as compared with normal animals. The state of vasoreactivity was closely related to the resting potential of vascular smooth muscle in hemorrhagic shock, with a correlation coefficient of 0.96. Treatment with glybenclamide, a selective blocker of ATP-sensitive K+ (KATP) channels, decreased the resting potential, increased NE-stimulated [Ca2+]i increase, and partially restored vasoreactivity in severe hemorrhagic shock. CONCLUSION: The results suggested that membrane hyperpolarization and the reduction of NE-stimulated [Ca2+]i increase in smooth muscle cells appeared to contribute to the vascular hyporeactivity in hemorrhagic shock. The mechanism is likely to involve in KATP channels.

关键词： Animals Calcium glyburide Membrane Potentials Muscle, Smooth, Vascular Norepinephrine Potassium Channels Rats Rats, Sprague-Dawley Shock, Hemorrhagic

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Activation of ATP-sensitive potassium channels antagonize nociceptive behavior and hyperexcitability of DRG neurons from rats

Activation of ATP-sensitive potassium channels antagonize no...

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中国神经科学学会第九届全国学术会议暨第五次会员代表大会

作者： Xiao-Na DU,Chao WANG,Hai-Lin ZHANG~* The Key Laboratory of Neural and Vascular Biology,Ministry of Education,Department of Pharmacology,Hebei Medical University,Shijiazhuang,China

Nociceptive responses to noxious stimuli are initiated at peripheral nociceptor *** channels play a vital role in pain signal initiation and *** of K channels has been implicated in mediating the analgesic effects of agents such as ***,systematic studies regarding the effects of K activators on nociception and neuronal excitability are *** this study,we describe the antagonistic effects of K activators pinacidil and diazoxide on nocifensive behavior induced by bradykinin(BK),thermo and mechanical stimuli,and the bradykinin-induced hyperexcitability of DRG *** also found that K activators can moderately activate K in DRG *** the effects of K activators can be reversed by the K blocker glyburide,direct activation of K is most likely the underlying *** systematic study clearly demonstrates that activation of K could have significant modulatory effects on the excitability of sensory neurons and thus on sensory behaviors,such as nociception.K activators can be evaluated clinically for the treatment of pain symptoms.

关键词： KATP potassium channels DRG excitability nociception pinacidil diazoxide glyburide

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