Gestational diabetes & diabetes in pregnancy
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
Main finding · GDMResult — go to the resultRelative risk 0.967 95% CI 0.719–1.315Authors' conclusion
Preconception GLP-1RA or tirzepatide therapy with pre-pregnancy discontinuation was associated with GDM risk comparable to BMI-matched unexposed women despite a modest BMI rebound. However, abrupt discontinuation close to conception conferred a 53% higher GDM risk, indicating that any pharmacodynamic carry-over effect is contingent upon the discontinuation timing and velocity of weight rebound during gestation, rather than preconception exposure itself.
Study context
- Population
- Women (18–45 years) without pre-existing diabetes, TriNetX network, January 1, 2015-April 30, 2025; matched on demographics, numerical BMI, HbA1c and comorbiditiesmatched cohort
- Participants
- 892 women
- Exposure
- Preconception GLP-1 RA/tirzepatide use vs non-users
- Outcome
- GDM risk
Methodological detailsmultinational federated network (TriNetX), propensity score-matched 1:1
- Multinational federated network (TriNetX)
- Propensity score-matched 1:1
Main finding
GDM
Relative risk
0.967
95% CI 0.719–1.315
By group
As reported in the abstract
- Gestational BMI rebound, GLP-1RA/tirzepatide vs non-users
- +1.8 vs. +1.2 kg/m²; excess gain + 0.6 kg/m²
Observational data: associations, not effects.
Further findings
Mean, kg/m²
| Outcome | Treated | Untreated | RR (95% CI) | |
|---|---|---|---|---|
| Sensitivity analysis matched on pre-treatment window: GDM incidence and residual mean BMIGDM | 37.0 | 35.0 | 0.988 (0.701–1.378) | |
| 0.512Relative risk (log scale) |
Gestational diabetes mellitus (GDM) risk with abrupt discontinuation (prescription issuance ≤90 days pre-index)
- Increase in GDM risk
- 53%
- Excess BMI gain
- + 1.3 kg/m²
- Matched cohorts
Sensitivity analysis matched on pre-treatment window: GDM incidence and residual mean BMI
- Similar GDM incidence
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
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