Use of hypoglycemic drugs during lactation.
OBJECTIVE
My patient was taking glipizide (an oral sulfonylurea) for type 2 diabetes. Now she is pregnant and taking insulin instead. She is very anxious to return to her previous treatment immediately after delivery because of the pain and hurdles associated with the administration of insulin. Can sulfonylureas cross into human milk and, if so, is it safe for her to breastfeed her infant?


CONCLUSIONS
The exposure of infants to second-generation sulfonylureas (eg, glipizide, glyburide) through breast milk is expected to be minimal, based on the limited data available. Women with type 2 diabetes treated with sulfonylureas should not be discouraged from breastfeeding. The benefits of breastfeeding greatly outweigh the risks of these medications, if any. The baby should, however, be monitored for signs of hypoglycemia.
Hospital for Sick Children, Toronto, Ontario.
Miguel Marcelo
MM
Glatstein
Nada
N
Djokanovic
Facundo
F
Garcia-Bournissen
Yaron
Y
Finkelstein
Gideon
G
Koren
D000284:Administration, Oral; D001942:Breast Feeding; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy*; D064420:Drug-Related Side Effects and Adverse Reactions; D005260:Female; D005913:Glipizide / Q000008:administration & dosage / Q000009:adverse effects; D005905:Glyburide / Q000008:administration & dosage / Q000009:adverse effects; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage* / Q000009:adverse effects; D007231:Infant, Newborn; D007774:Lactation / Q000187:drug effects*; D008429:Maternal Welfare; D008895:Milk, Human / Q000187:drug effects; D011247:Pregnancy; D011254:Pregnancy in Diabetics / Q000188:drug therapy; D018570:Risk Assessment; D013453:Sulfonylurea Compounds / Q000008:administration & dosage / Q000009:adverse effects
D007004:Hypoglycemic Agents; D013453:Sulfonylurea Compounds; D005905:Glyburide; D005913:Glipizide