Glatstein Miguel Marcelo, Djokanovic Nada, Garcia-Bournissen Facundo, Finkelstein Yaron, Koren Gideon
Hospital for Sick Children, Toronto, Ontario.
Can Fam Physician. 2009 Apr;55(4):371-3.
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?
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.
我的患者患有2型糖尿病,之前一直在服用格列吡嗪(一种口服磺脲类药物)。现在她怀孕了,改为使用胰岛素治疗。由于注射胰岛素带来的痛苦和不便,她非常渴望在产后立即恢复之前的治疗。磺脲类药物会进入母乳吗?如果会,她母乳喂养婴儿是否安全?
根据现有有限数据,预计婴儿通过母乳接触第二代磺脲类药物(如格列吡嗪、格列本脲)的量极少。使用磺脲类药物治疗的2型糖尿病女性不应被劝阻进行母乳喂养。母乳喂养的益处远大于这些药物可能存在的风险。不过,应监测婴儿是否有低血糖迹象。