Pre-Pregnancy GLP-1 Agonist Use and Gestational Diabetes Risk
Pre-Pregnancy GLP-1 Receptor Agonist or Tirzepatide Use and Gestational Diabetes Risk: Evaluating Pharmacodynamic Carry-Over Versus Post-Discontinuation Metabolic Rebound in a Multinational Federated Cohort.
Background
Glucagon-like peptide-1 receptor agonists (GLP-1RAs) and tirzepatide are highly effective for managing type 2 diabetes and obesity. However, there's a critical gap in understanding their long-term metabolic impact on subsequent pregnancies, particularly the risk of gestational diabetes mellitus (GDM), after preconception discontinuation. This study aimed to evaluate if preconception GLP-1RA/tirzepatide use influences GDM risk, specifically distinguishing between beneficial pharmacodynamic carry-over effects and potential metabolic rebound post-discontinuation.
Study Design
Population
Women with type 2 diabetes or obesity planning pregnancy who are currently on GLP-1RA or tirzepatide.
Intervention
Preconception discontinuation of GLP-1RA or tirzepatide at varying timeframes before pregnancy.
Outcome
The risk of gestational diabetes mellitus (GDM) following preconception discontinuation of GLP-1RA/tirzepatide.