Introduction: Gestational diabetes mellitus (GDM) is a known risk of developing type 2 diabetes mellitus in the future. The prevalence of glucose intolerance in the early postpartum period among women with GDM ranges between 13.5% to 50%, depending on the population. This study aims to estimate the prevalence of glucose intolerance 6 to 12 weeks postpartum and its associated factors among women with GDM in Putrajaya, a federal government administrative centre of Malaysia. Methods: All women with history of GDM who had oral glucose tolerance test (OGTT) done 6 to 12 weeks postpartum at Putrajaya clinic from June 2013 to December 2016 were included. Sociodemographic data, details of GDM diagnosis and management, and postpartum OGTT results were collected. Results: There were 443 women with a mean age of 31.7 years. Postpartum OGTT showed 58 (13.2%) had prediabetes and 10 (2.1%) had diabetes. The independent risk factors associated with early postpartum glucose intolerance were 2-hour plasma glucose of diagnostic OGTT, gestational age of GDM diagnosis and HbA1c level in pregnancy. Conclusion: A diagnosis of postpartum glucose intolerance can occur early in women with history of GDM. Factors such as 2-hour plasma glucose of diagnostic OGTT, gestational age of GDM diagnosis and HbA1c level increase the risk of postpartum glucose intolerance.

Objectives: This study aimed to compare the severity of COVID-19, inflammatory parameters and clinical outcomes among patients with normal and subnormal levels of Vitamin D. Methodology: This is a retrospective cohort study of 135 patients admitted in a tertiary hospital for COVID-19. Patients were grouped according to their Vitamin D level. Primary outcome measure was the composite of all-cause mortality and morbidity. Other outcome measures determined were the comparison among the groups on the severity of COVID-19 infection, changes in inflammatory parameters, length of hospital stay and duration of respiratory support. Results: There was a significant trend of higher ICU admission, mortality (p-value= 0.006) and poor clinical outcome (p-value=0.009) among the Vitamin D deficient group. No significant difference was found for most of the inflammatory parameters, duration of hospital stay and respiratory support. Overall, patients with deficient, but not insufficient Vitamin D level had 6 times higher odds of composite poor outcome than those with normal Vitamin D (crude OR=5.18, p-value= 0.003; adjusted OR =6.3, p-value=0.043). Conclusion The inverse relationship between Vitamin D level and poor composite outcome observed in our study suggests that low Vitamin D may be a risk factor for poor prognosis among patients admitted for COVID-19.
type 2 diabetes mellitus ; Non-alcoholic Fatty Liver disease