{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,22]],"date-time":"2026-08-22T12:53:17Z","timestamp":1787403197943,"version":"build-2736575974"},"reference-count":60,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T00:00:00Z","timestamp":1770768000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T00:00:00Z","timestamp":1770768000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000865","name":"Bill and Melinda Gates Foundation","doi-asserted-by":"publisher","award":["INV052005"],"award-info":[{"award-number":["INV052005"]}],"id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000272","name":"National Institute for Health and Care Research","doi-asserted-by":"publisher","award":["NIHR304266"],"award-info":[{"award-number":["NIHR304266"]}],"id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["ascpt.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clin Pharma and Therapeutics"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:p>\n                    This review evaluates the available pharmacokinetic data on the plasma\u2010to\u2010breastmilk transfer of first\u2010 and second\u2010line T2DM drugs against available clinical guideline recommendations. A list of drug therapies for treating T2DM was generated from national and international clinical guidelines. A systematic search of research articles reporting human plasma and breastmilk drug concentrations was conducted in Scopus, PubMed, Google Scholar, and LactMed\u00ae in accordance with the Preferred Reporting Items for Systematic Reviews and Meta\u2010Analyses (PRISMA) guidelines. Studies evaluating breastmilk drug transfer in T2DM, with fully accessible abstract and main text reported in English, were included. Study quality was evaluated using the ClinPK checklist. Authors evaluated clinical guideline recommendations on the use of T2DM drugs in lactation and the basis upon which such recommendations were made. Only 5 out of 20 drugs (\n                    <jats:italic>metformin<\/jats:italic>\n                    ,\n                    <jats:italic>glyburide<\/jats:italic>\n                    ,\n                    <jats:italic>glipizide<\/jats:italic>\n                    ,\n                    <jats:italic>tolbutamide<\/jats:italic>\n                    ,\n                    <jats:italic>and semaglutide<\/jats:italic>\n                    ) have clinical data on plasma\u2010to\u2010breastmilk transfer. Metformin and tolbutamide were detectable in maternal plasma and breastmilk. Half (51.7%) of guideline recommendations provide explicit guidance. Only 4.4% of recommendations were based on clinical evidence. Over half (57.8%) of recommendations were accessible online, and most guideline recommendations (78%) were against the use of antiglycemic agents while breastfeeding. The scarce clinical evidence to guide T2DM drug therapy during breastfeeding available has several design and methodological limitations. Published recommendations remain largely inconsistent, thus perpetuating uncertainty in the use of T2DM drug therapies in lactation. Addressing knowledge gaps is critical in developing clinical consensus to optimize T2DM drug therapy among breastfeeding mothers.\n                  <\/jats:p>","DOI":"10.1002\/cpt.70211","type":"journal-article","created":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T13:47:34Z","timestamp":1770817654000},"page":"1223-1234","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Maternal\u2010to\u2010Infant Transfer of Medications for Type 2 Diabetes Mellitus Via Breastmilk: A\u00a0Systematic Review of Available Evidence and\u00a0Clinical Guidelines"],"prefix":"10.1002","volume":"119","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-3491-1514","authenticated-orcid":false,"given":"Katherine","family":"Richardson","sequence":"first","affiliation":[{"name":"School of Medicine University of Liverpool  Liverpool UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8077-6666","authenticated-orcid":false,"given":"Joshua","family":"Kiptoo","sequence":"additional","affiliation":[{"name":"Infectious Diseases Institute Makerere University  Kampala Uganda"},{"name":"Department of Pharmacy, Faculty of Medicine Mbarara University of Science &amp; Technology  Mbarara Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6283-9114","authenticated-orcid":false,"given":"Beatrice","family":"Mpora Odongkara","sequence":"additional","affiliation":[{"name":"Department of Pediatrics &amp; Child Health, Faculty of Medicine Gulu University  Gulu Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6425-6828","authenticated-orcid":false,"given":"Francis Williams","family":"Ojara","sequence":"additional","affiliation":[{"name":"Infectious Diseases Institute Makerere University  Kampala Uganda"},{"name":"Department of Pharmacology and Therapeutics, Faculty of Medicine Gulu University  Gulu Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0134-5855","authenticated-orcid":false,"given":"Catriona","family":"Waitt","sequence":"additional","affiliation":[{"name":"Infectious Diseases Institute Makerere University  Kampala Uganda"},{"name":"Department of Women\u2019s and Children\u2019s Health, School of Medicine University of Liverpool  Liverpool UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,2,11]]},"reference":[{"key":"e_1_2_10_1_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(23)01301-6"},{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc16-1616"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.2337\/db20211-13"},{"issue":"1","key":"e_1_2_10_4_1","first-page":"S181","article-title":"9. 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