Introduction: Gestational diabetes mellitus (GDM) is a common pregnancy complication associated with adverse maternal and neonatal outcomes, including hypertensive disorders, caesarean delivery, macrosomia, and increased lifetime risk of type 2 diabetes. Despite its clinical importance, considerable international variation exists in GDM screening and diagnostic criteria. Multiple frameworks are currently used, including those from the World Health Organization (WHO), International Association of Diabetes and Pregnancy Study Groups, Carpenter and Coustan, and the National Diabetes Data Group. Differences in glucose thresholds, testing protocols (one-step versus two-step), and universal versus risk-based screening contribute to heterogeneity in reported prevalence and healthcare burden. In multi-ethnic, middle-income settings such as Malaysia, identifying an evidence-informed and contextappropriate diagnostic approach is critical. Methodology: This scoping review follows the Joanna Briggs Institute methodology and will be reported in accordance with the PRISMA Extension for Scoping Reviews (PRISMA-ScR). PubMed, Scopus, and ScienceDirect will be searched for English-language studies, reviews, guidelines, and consensus statements reporting GDM diagnostic criteria. Two reviewers will independently screen and select studies. Results: Data will be charted on country, study type, diagnostic criteria, gestational age at screening, and reported challenges. Findings will be synthesized descriptively and presented in tables and figures. No formal risk-of-bias assessment will be conducted. Conclusion This review will provide a comprehensive overview of global diagnostic practices, highlight variations and gaps, and support evidence-based selection of a suitable GDM screening and diagnostic strategy for Malaysia.
Diabetes, Gestational ; Malaysia ; Policy ; Review Literature as Topic

Introduction: Hypertension is common in obesity and increases cardiovascular risk. Bariatric surgery improves metabolic health, but subgroup differences in blood pressure response remain unclear. This study examined 1-year changes in systolic blood pressure (SBP) and diastolic blood pressure (DBP) after bariatric surgery across sex, age group, and diabetes status. Methodology: This study included 32 obese adults undergoing bariatric surgery, with blood pressure measured at baseline, 6 and 12 months. Generalized estimating equation models were used to evaluate changes in SBP and DBP over time, adjusting for age, sex, surgery type, diabetes category, baseline body mass index, antihypertensive medication use, and baseline blood pressure. Interaction terms were tested to assess differences in blood pressure trajectories across subgroups. Results: Participants were predominantly female (67.4%), with a mean age of 36.9 ± 6.2 years and a mean body mass index of 40.7 ± 8.8 kg/m². Hypertension and diabetes were present in 40.6 and 31.3% of participants, respectively. There was a significant time effect for both SBP (p <0.001) and DBP (p = 0.004). At 12 months post-surgery, mean SBP decreased by 15 mmHg and DBP by 7.9 mmHg compared with baseline (both p <0.001). No significant interactions were observed between time and sex, diabetes category, or age category, indicating that blood pressure improvements were comparable across subgroups. Conclusion Bariatric surgery was associated with clinically meaningful reductions in both SBP and DBP, with similar improvement patterns observed across demographic and metabolic subgroups. These findings support the effectiveness of bariatric surgery as a strategy for blood pressure reduction and cardiovascular risk management in patients with obesity.
Blood Pressure ; Bariatric Surgery

Introduction: Cadmium (Cd) in urine and inhaled dust of the municipal waste operators was assessed. Methods: Urine spot samples were collected and analysed for Cd and creatinine of 60 municipal waste operators between April to June 2013. Respirable dust was collected using personal air sampling pump GilAir-3 and GilAir-5 for 8 working hours. Cd in urine and dust were analysed using the Flame Atomic Absorption Spectrometer (Perkin Elmer A Analyst 800) while urinary creatinine was measured using Reflotron® Plus creatinine. Results: The mean and standard deviation (SD) of Cd in the respirable dust (0.59 ± 50.27 μg/m3) was within the permissible exposure limit (PEL). The level of Cd in urine (0.015 ± 0.0097 μg/g Cr) was lower than the safe limit of 5 μg/g. The creatinine level (173.59 ± 50.27 mg/dl) was within the normal range (20 to 350 mg/dl). The multiple regression model shows smoking and years of smoking were the significant predictors for the Cd in the urine (R² = 0.216 F(3,56) = 5.150, p < 0.05). Conclusion: Municipal waste operators were exposed to minimal Cd exposure while handling waste and the accumulation of this metal urine was correlated with smoking habit.