Diabetes, Gestational

FRIDAY, Jan. 10, 2025 -- In nulliparous pregnant individuals, higher radon exposure is associated with greater odds of gestational diabetes (GD), according to a study published online Jan. 10 in JAMA Network Open . Yijia Zhang, Ph.D., from the Columbia University Irving Medical Center in New York City, and colleagues examined the association of county-level radon exposure with GD risk in a multicenter, population-based cohort study using data from the Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-to-Be cohort. Data were included for 9,107 participants; 41.6 percent had ever used tobacco. The researchers found that the mean county-level radon concentration was 1.6 pCi/L; 4.2 percent of participants had GD recorded. The odds of developing GD were higher for individuals living in counties with the highest radon level (≥2 pCi/L) compared with those living in counties with the lowest radon level (<1 pCi/L), after adjustment for potential confounders (odds ratio, 1.37; 95 percent confidence interval, 1.41 to 3.11); the odds ratio was attenuated to 1.36 (95 percent confidence interval, 1.00 to 1.86) after additional adjustment for fine particulate matter air pollutants (PM 2.5 ). Ever smokers living in counties with a higher (≥2 pCi/L) radon level and those living in counties with higher radon and PM 2.5 levels had elevated odds of GD (odds ratios [95 percent confidence intervals], 2.09 [1.41 to 3.11] and 1.93 [1.31 to 2.83], respectively), although there were no statistically significant interactions. "This study provides a foundation for future research focusing on individual-level indoor radon measurement to confirm the findings and explore the underlying biological mechanisms," the authors write. Several authors disclosed ties to the health care industry. Abstract/Full Text Editorial Whatever your topic of interest, subscribe to our newsletters to get the best of Drugs.com in your inbox.

THURSDAY, Jan. 9, 2025 -- With respect to the proportion of infants born large for gestational age, treatment of gestational diabetes with metformin and glyburide , if needed, does not meet the criteria for noninferiority versus insulin, according to a study published online Jan. 6 in the Journal of the American Medical Association . Doortje Rademaker, M.D., from the Amsterdam University Medical Center, and colleagues examined whether a treatment strategy of oral glucose-lowering agents is noninferior to insulin for prevention of large-for-gestational-age infants in a randomized trial conducted at 25 Dutch centers. A total of 820 individuals with gestational diabetes and singleton pregnancies between 16 and 34 weeks of gestation, with insufficient glycemic control after two weeks of dietary changes, were randomly assigned to receive metformin or insulin (409 and 411 participants, respectively). Glyburide was added to metformin, and if needed to achieve glucose targets, insulin was then substituted for glyburide. Overall, 79 percent of the participants randomly assigned to oral agents maintained glycemic control without insulin. The researchers found that 23.9 and 19.9 percent of infants were large for gestational age with oral agents and insulin, respectively (absolute risk difference, 4.0 percent; 95 percent confidence interval, −1.7 to 9.8 percent; P = 0.09 for noninferiority), with the confidence interval exceeding the absolute noninferiority margin of 8 percent. "These findings contribute to existing trial data regarding the use of metformin and glyburide as alternatives for insulin to manage gestational diabetes," the authors write. Several authors disclosed ties to the pharmaceutical industry.

MONDAY, Dec. 23, 2024 -- Moderate- to vigorous-intensity physical activity (MVPA) during pregnancy is inversely associated with preterm birth in women with gestational diabetes (GD), according to a study published online Dec. 19 in JAMA Network Open . Wanglong Gou, Ph.D., from Westlake Laboratory of Life Sciences and Biomedicine in China, and colleagues examined the association of accelerometer-derived physical activity metrics and patterns with preterm birth among women with GD. The analysis included 1,427 women with GD with wearable accelerometer-derived physical activity data. The researchers found an inverse relationship between an increase in MVPA and the fraction of physical activity energy expenditure derived from MVPA with preterm birth (odds ratio per 30 minutes, 0.64 and 0.69, respectively). There was a progressive decrease in the odds of preterm birth with increasing duration of MVPA per day, which reached a plateau at 74 minutes per day. The benefit was similar whether active MVPA (≥30 minutes per day) was concentrated into a few days or followed a more regular pattern. "These findings provide key evidence for the health benefits of MVPA during pregnancy and lay the foundation for establishing physical activity guidelines for pregnant women with GD," the authors write. Abstract/Full Text Whatever your topic of interest, subscribe to our newsletters to get the best of Drugs.com in your inbox.