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Use of hypoglycemic drugs during lactation

Miguel Marcelo Glatstein, MD, Nada Djokanovic, MD MSc, Facundo Garcia-Bournissen, MD, Yaron Finkelstein, MD and Gideon Koren, MD FRCPC FACMT

April 2009



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.


Ma patiente prenait du glipizide (sulfonylurée par voie orale) pour un diabète de type 2. Elle est maintenant enceinte et prend plutôt de l’insuline. Elle a bien hâte de revenir à son ancien traitement et veut le faire immédiatement après l’accouchement à cause de la douleur et des embarras associés à l’administration d’insuline. Est-ce que les sulfonylurées peuvent passer dans le lait maternel et, dans l’affirmative, est-il sécuritaire pour elle d’allaiter son nourrisson?


Selon les données limitées à notre disposition, on pourrait s’attendre à ce que l’exposition du nourrisson aux sulfonylurées de deuxième génération (p. ex., glipizide, glyburide) par l’intermédiaire du lait maternel soit minimale. Il ne faudrait pas décourager les femmes ayant un diabète de type 2 et traitées aux sulfonylurées d’allaiter leur enfant. Les avantages de l’allaitement dépassent largement les risques de ces médicaments, s’il en est. Il faudrait par ailleurs surveiller chez le bébé tout signe d’hypoglycémie.

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