Introduction: The role of dietary intake on maternal glucose is uncertain. This study described the dietary characteristics of women with gestational diabetes mellitus (GDM) and examined the differences in dietary characteristics based on GDM diagnosis. Methods: This study recruited GDM women (n =45; age =31.1±5.1 years old) from health clinics in Seremban. Dietary intake, glycemic index (GI) and glycemic load (GL) were assessed using a semi-quantitative food frequency questionnaire (SFFQ) during first and second trimester of pregnancy. GDM diagnosis was made at 28 weeks gestation with the following cut-off for FPG ≥ 5.1 or 2hPG ≥ 7.8 mmol/L following oral glucose tolerance test. Results: Women with GDM had a reasonable intake of protein and fat but consumed high-carbohydrate at second trimester and high-sugar diet at both trimesters. Fibre, iron and calcium from the food sources did not meet the recommended nutrient intakes for pregnancy. About 75.6% (n = 34) GDM women had high 2hPG (9.3 ± 1.5 mmol/L) with a normal FPG (4.7 ± 0.7 mmol/L). While dietary characteristics were not significantly different, women with a higher 2hPG tended to take a higher proportion of protein at first trimester and a higher dietary GI, serving of rice, and sugars and creamer at second trimester than high FPG. Conclusion: Suboptimal maternal nutrition in women with GDM are of particular concern. Dietary characteristics of women with high fasting and 2-hour glucose were comparable but not optimal. The needs of tailored nutritional intervention are evident in women known to be at high risk of GDM.
Gestational diabetes mellitus (GDM) ;

Statins represent the first-line therapy for cholesterol management. However, for patients prone to statin side effects, unable to tolerate higher doses, or requiring additional low-density lipoprotein cholesterol (LDL-C) reduction, ezetimibe alone or in combination with statins is recommended. This meta-analysis aimed to evaluate the safety and efficacy of combining lowor moderate-intensity statins with ezetimibe compared to high-intensity statin monotherapy, yielding reliable evidence to guide clinical decision-making and personalize treatment strategies. PubMed, Embase, and Scopus were systematically searched from inception until May 2023. All randomized controlled trials (RCTs) comparing a high-intensity statin with a low/ moderate-intensity statin with ezetimibe were included. The outcomes of interest comprised changes in concentrations of lipids—LDL-C, high-density lipoprotein cholesterol (HDL-C), total cholesterol (TC), and triglycerides (TGs)—and apolipoprotein (Apo) A1, Apo B, and high-sensitivity C-reactive protein (hs-CRP), along with major adverse cardiovascular events (MACE). All data were analyzed using Review Manager version 5.4. p-values less than 0.05 were considered to indicate statistical significance. Overall, 20 RCTs, with 5,412 participants, were included. A low/moderate-intensity statin combined with ezetimibe yielded a significantly greater reduction in LDL-C levels than high-intensity statin monotherapy (mean difference [MD], −6.59; 95% confidence interval [CI], −10.95, −2.24; p=0.003; I 2 =84%). No significant differences were observed between combination and high-intensity statin monotherapy regarding TC, TG, or HDL-C levels. However, hs-CRP levels were significantly higher with combination therapy (MD, 0.32; 95% CI, 0.01, 0.64; p=0.04; I 2 =0%). Combination therapy involving a low/moderate-intensity statin with ezetimibe was significantly associated with lower LDL-C levels than high-intensity statin monotherapy. No significant differences were observed for TC, TGs, HDL-C, alanine transaminase, or MACE. However, creatine phosphokinase levels significantly increased with monotherapy.

Statins represent the first-line therapy for cholesterol management. However, for patients prone to statin side effects, unable to tolerate higher doses, or requiring additional low-density lipoprotein cholesterol (LDL-C) reduction, ezetimibe alone or in combination with statins is recommended. This meta-analysis aimed to evaluate the safety and efficacy of combining lowor moderate-intensity statins with ezetimibe compared to high-intensity statin monotherapy, yielding reliable evidence to guide clinical decision-making and personalize treatment strategies. PubMed, Embase, and Scopus were systematically searched from inception until May 2023. All randomized controlled trials (RCTs) comparing a high-intensity statin with a low/ moderate-intensity statin with ezetimibe were included. The outcomes of interest comprised changes in concentrations of lipids—LDL-C, high-density lipoprotein cholesterol (HDL-C), total cholesterol (TC), and triglycerides (TGs)—and apolipoprotein (Apo) A1, Apo B, and high-sensitivity C-reactive protein (hs-CRP), along with major adverse cardiovascular events (MACE). All data were analyzed using Review Manager version 5.4. p-values less than 0.05 were considered to indicate statistical significance. Overall, 20 RCTs, with 5,412 participants, were included. A low/moderate-intensity statin combined with ezetimibe yielded a significantly greater reduction in LDL-C levels than high-intensity statin monotherapy (mean difference [MD], −6.59; 95% confidence interval [CI], −10.95, −2.24; p=0.003; I 2 =84%). No significant differences were observed between combination and high-intensity statin monotherapy regarding TC, TG, or HDL-C levels. However, hs-CRP levels were significantly higher with combination therapy (MD, 0.32; 95% CI, 0.01, 0.64; p=0.04; I 2 =0%). Combination therapy involving a low/moderate-intensity statin with ezetimibe was significantly associated with lower LDL-C levels than high-intensity statin monotherapy. No significant differences were observed for TC, TGs, HDL-C, alanine transaminase, or MACE. However, creatine phosphokinase levels significantly increased with monotherapy.

Statins represent the first-line therapy for cholesterol management. However, for patients prone to statin side effects, unable to tolerate higher doses, or requiring additional low-density lipoprotein cholesterol (LDL-C) reduction, ezetimibe alone or in combination with statins is recommended. This meta-analysis aimed to evaluate the safety and efficacy of combining lowor moderate-intensity statins with ezetimibe compared to high-intensity statin monotherapy, yielding reliable evidence to guide clinical decision-making and personalize treatment strategies. PubMed, Embase, and Scopus were systematically searched from inception until May 2023. All randomized controlled trials (RCTs) comparing a high-intensity statin with a low/ moderate-intensity statin with ezetimibe were included. The outcomes of interest comprised changes in concentrations of lipids—LDL-C, high-density lipoprotein cholesterol (HDL-C), total cholesterol (TC), and triglycerides (TGs)—and apolipoprotein (Apo) A1, Apo B, and high-sensitivity C-reactive protein (hs-CRP), along with major adverse cardiovascular events (MACE). All data were analyzed using Review Manager version 5.4. p-values less than 0.05 were considered to indicate statistical significance. Overall, 20 RCTs, with 5,412 participants, were included. A low/moderate-intensity statin combined with ezetimibe yielded a significantly greater reduction in LDL-C levels than high-intensity statin monotherapy (mean difference [MD], −6.59; 95% confidence interval [CI], −10.95, −2.24; p=0.003; I 2 =84%). No significant differences were observed between combination and high-intensity statin monotherapy regarding TC, TG, or HDL-C levels. However, hs-CRP levels were significantly higher with combination therapy (MD, 0.32; 95% CI, 0.01, 0.64; p=0.04; I 2 =0%). Combination therapy involving a low/moderate-intensity statin with ezetimibe was significantly associated with lower LDL-C levels than high-intensity statin monotherapy. No significant differences were observed for TC, TGs, HDL-C, alanine transaminase, or MACE. However, creatine phosphokinase levels significantly increased with monotherapy.

Statins represent the first-line therapy for cholesterol management. However, for patients prone to statin side effects, unable to tolerate higher doses, or requiring additional low-density lipoprotein cholesterol (LDL-C) reduction, ezetimibe alone or in combination with statins is recommended. This meta-analysis aimed to evaluate the safety and efficacy of combining lowor moderate-intensity statins with ezetimibe compared to high-intensity statin monotherapy, yielding reliable evidence to guide clinical decision-making and personalize treatment strategies. PubMed, Embase, and Scopus were systematically searched from inception until May 2023. All randomized controlled trials (RCTs) comparing a high-intensity statin with a low/ moderate-intensity statin with ezetimibe were included. The outcomes of interest comprised changes in concentrations of lipids—LDL-C, high-density lipoprotein cholesterol (HDL-C), total cholesterol (TC), and triglycerides (TGs)—and apolipoprotein (Apo) A1, Apo B, and high-sensitivity C-reactive protein (hs-CRP), along with major adverse cardiovascular events (MACE). All data were analyzed using Review Manager version 5.4. p-values less than 0.05 were considered to indicate statistical significance. Overall, 20 RCTs, with 5,412 participants, were included. A low/moderate-intensity statin combined with ezetimibe yielded a significantly greater reduction in LDL-C levels than high-intensity statin monotherapy (mean difference [MD], −6.59; 95% confidence interval [CI], −10.95, −2.24; p=0.003; I 2 =84%). No significant differences were observed between combination and high-intensity statin monotherapy regarding TC, TG, or HDL-C levels. However, hs-CRP levels were significantly higher with combination therapy (MD, 0.32; 95% CI, 0.01, 0.64; p=0.04; I 2 =0%). Combination therapy involving a low/moderate-intensity statin with ezetimibe was significantly associated with lower LDL-C levels than high-intensity statin monotherapy. No significant differences were observed for TC, TGs, HDL-C, alanine transaminase, or MACE. However, creatine phosphokinase levels significantly increased with monotherapy.

Introduction: There is limited evidence on dietary patterns and the risk of type 2 diabetes (T2D) in women with a history of gestational diabetes mellitus (GDM) compared to their non-GDM counterparts, especially in the Asian population. The pilot study investigated dietary patterns in women with a history of GDM (HGDM) and without a history of GDM (non-HGDM), and the association with T2D risk. Methods: This comparative cross-sectional study involved 64 women (32 HGDM, 32 non-HGDM). Food intake was assessed using a validated food frequency questionnaire. Principal component analysis derived the dietary patterns. T2D risk score was determined using the Finnish Diabetes Risk Score tool. Results: HGDM group had significantly higher proportion of first-degree family history of diabetes; higher risk of T2D and better diabetes knowledge; lower gestational weight gain and postpartum weight retention; and consumed more fast food than nonHGDM. ‘Rice-noodle-pasta-meat’ dietary pattern was significantly associated with increased T2D risk after adjusting for age (β=0.272, p=0.032). ‘Bread-cereals-fast food-meat’ dietary pattern was positively and significantly associated with T2D risk after adjusting for confounders, including age, education level, family history of diabetes, diabetes knowledge score, gestational weight gain, and postpartum weight retention (β=0.251, p=0.012). Conclusion: Dietary patterns high in bread, cereals and cereal products, fast food and meat, as well as rice, noodle, pasta and meat were associated with an elevated T2D risk. A more extensive study is warranted to establish the association between dietary patterns and risk of T2D, focusing on women with a history of GDM.

Introduction: Low glycemic index (GI) diet is recommended as part of medical nutrition therapy for the management of gestational diabetes mellitus (GDM). While the clinical benefits are evident, data assessing knowledge of the GI concept among women with GDM are scarce. This was a needs assessment study to determine the level of knowledge about the GI concept among women with GDM. Methods: Using a cross-sectional design, we included 85 women with GDM (mean age: 30.6 ± 4.0, pre-pregnancy BMI: 24.8 ± 4.1 kg/m2, gestational age: 34.0 ± 4.0 weeks) from Hospital Serdang, Malaysia. Knowledge about the GI concept was assessed using a developed questionnaire. Additional questions on GDM were assessed using Gestational Diabetes Mellitus Knowledge Questionnaire (GDMKQ). Subjects with less than 50%, 51-74%, and more than 75% total score were categorized as having poor, fair, and good knowledge levels, respectively. Results: The mean knowledge score obtained by the subjects was 12.8 ± 3.5. More subjects scored correctly for GDM-related knowledge (68.2%). More than half (58.8%) had heard about the GI concept previously and 55.3% understood the definition of GI. The average knowledge score about the GI concept was 55.6%; subjects scored highest on the influence of different carbohydrates (teh tarik versus milk) on blood glucose level (87.1%). However, the majority of the subjects had fair knowledge level (62.4%). Conclusion: Women with GDM had moderate knowledge about the GI concept. Results of the needs assessment served as preliminary data for the development of a GI-based nutrition education program in Malaysia.