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  • October 12, 2017 7:52 AM | Ashley Monson (Administrator)

    FRIDAY, Oct. 6, 2017 (HealthDay News) -- In a move that could affect millions of American women, the Trump Administration is poised to roll back a federal mandate requiring that birth control be available as part of employer-based health plans.

    Instead, new rules -- expected as early as Friday -- would give employers much wider leeway to declare themselves exempt from providing contraception due to moral or religious objections, The New York Times reported.

    More than 55 million women currently have access to free birth control due to the contraceptive coverage mandate, according to data compiled under the Obama administration. The new rules would also affect hundreds of thousands of women who get free contraception under the Affordable Care Act.

    The expected action from the White House fulfills a promise President Donald Trump made to voters during the 2016 election campaign.

    According to the Times, wording in the new rules offers an exemption to any employer based on "moral convictions" or because it objects to covering birth control services "based on its sincerely held religious beliefs."

    The Trump administration wording says that expanding exemptions was needed so that all religious objections to contraceptive coverage could be accommodated. "Application of the mandate to entities with sincerely held religious objections to it does not serve a compelling governmental interest," it says.

    The birth control mandate was the focus of intense litigation during the Obama Administration, as companies, hospitals, charitable groups and other organizations with moral objections sought to distance themselves from providing birth control to female employees. In one such case, an order of nuns called the Little Sisters of the Poor said the mandate would make them "morally complicit in grave sin," the Times reported.

    On the campaign trail, Trump told voters that he would "make absolutely certain religious orders like the Little Sisters of the Poor are not bullied by the federal government because of their religious beliefs."

    But the new move is expected to prompt even more legal battles -- this time from groups advocating for women and public health.

    In a statement, Dr. Anne Davis, consulting medical director for Physicians for Reproductive Health, said the rollback could send many American women "back to the days when patients couldn't afford the birth control that helps them live healthier lives."

    "No matter where they work, women need and deserve birth control access," Davis said. "An employer's beliefs have no place in these private decisions, just as they would not in any other conversation about a patient's health care. It's a dangerous intrusion into a woman's privacy and her ability to get the care she needs."

    Dana Singiser, Planned Parenthood's vice president of public policy and government affairs, agreed.

    "Let's be clear: this rule has nothing to do with religion. Under the Affordable Care Act religious organizations already have an accommodation that still ensures their employees get coverage through other means," she said. "This rule is about taking away women's fundamental health care, plain and simple."

    But the Trump administration said that in expanding exemptions, it is honoring objections to contraceptive coverage on moral as well as purely religious grounds.

    "Congress has a consistent history of supporting conscience protections for moral convictions alongside protections for religious beliefs," the administration said.

    Companies that now decide to opt out of contraceptive coverage are required to notify employees, the new rules state.

    The new rules are to take effect immediately, the Trump administration said, because "it would be impracticable and contrary to the public interest to engage in full notice and comment rule-making." Public comments are being accepted, however.

    More information

    There's more on contraception at the American College of Obstetricians and Gynecologists.

    SOURCES: The New York Times; Oct. 5, 2017, news releases, Planned Parenthood Federation of America, Physicians for Reproductive Health

    -- E. J. Mundell

    Last Updated: Oct 6, 2017

    Copyright © 2017 HealthDay. All rights reserved.


  • October 11, 2017 8:41 AM | Ashley Monson (Administrator)
    by Michael Smith, North American Correspondent, MedPage


    October 06, 2017


    Action Points

    SAN DIEGO -- A few extra glasses of water a day could cut the risk of urinary tract infections for women plagued with recurrent episodes, a researcher said here.

    In a randomized trial, drinking about three extra pints of water a day cut the risk of uncomplicated acute cystitis (AUC) by about half, according to Thomas Hooton, MD, of the University of Miami School of Medicine.

    The extra water was also associated with fewer courses of antibiotics during the year-long study, Hooton told reporters here at the annual IDWeek meeting, sponsored jointly by the Infectious Diseases Society of American (IDSA), the Pediatric Infectious Diseases Society (PIDS), the Society for Healthcare Epidemiology of America (SHEA), and the HIV Medicine Association (HIVMA).

    The finding is not really a surprise, Hooton said -- doctors have long been telling women to drink more water to prevent or help treat recurring AUC.

    The idea makes sense, he said, because the conventional wisdom has been that disease-causing bacteria make their way from the vagina up the urethra to the bladder. Frequent flushing with urine can prevent the bacteria from sticking to bladder cells, growing, and causing disease.

    But while that's a good story, he said, there had been no real study of the issue. "You always want to have confirmatory data," Hooton said. "It helps to be able to say there's a well-done study that looked at this question very carefully and showed the risk was pretty dramatically reduced."

    To obtain that data, he and colleagues enrolled 140 premenopausal women whose self-reported fluid intake was low -- less than 1.5 liters of total fluid a day -- and who had had at least three episodes of AUC in the previous year.

    They were randomly assigned 1:1 to increase their water intake by 1.5 L a day or to make no change in their habits.

    The investigators had monthly telephone calls with all participants as well as regular clinic visits in which such things as urine volume and osmolality -- a measure of the concentration of the fluid -- were tested.

    Women in the intervention group were given 500 mL bottles of water and urged to begin drinking one at the start of each meal and to finish it before the next meal, Hooton said.

    Over the study period, the 70 women in the intervention group:

    • Increased their water intake significantly compared with the control group -- an increase of 1.15 L on average versus an average drop of 0.01 L
    • Raised their average total fluid intake by 1.65 L versus 0.03 L among the control group
    • Upped average urine volume and number of urine voids -- 1.40 L versus 0.04 L and 2.2 a day versus a decrease of 0.2, respectively
    • Saw a decrease in urine osmolality of 408 mOsm/kg versus 35 in controls

    But the key finding, Hooton said, was that the average number of recurrent AUC episodes in the water group over the year was 1.6, compared with 3.1 among the control women. Those number yielded an odds ratio for AUC of 0.52, which was highly significant, he said.

    As might be expected, the average number of antimicrobial regimens used to treat AUC was 1.8 in the water group and 3.5 in the control group, which was again significant. As well, he noted, the average number of days to first AUC after the start of the study and the mean number of days between episodes was longer for those in the water group.

    The findings are important because many women suffer recurrent AUC and most are treated with antibiotics, commented Susan Bleasdale, MD, of the University of Illinois at Chicago, who moderated a media briefing on the trial.

    The study, she told reporters, "may be a game-changer" in the way antibiotics are used.

    The usual advice doctors give women to keep hydrated often comes when they are already in the throes of an infection -- advice often given along with a prescription for antibiotics. The point of the study, she said, is that increased water intake appears to prevent the infections in the first place -- and therefore the need for scripts.

    While the study took place among premenopausal women at risk for recurrent AUC, Hooton said he sees no reason it would not apply to those past the menopause, as well as to women of all ages who suffer less frequent attacks. But he added that hasn't yet been demonstrated.

    Hooton said he had no disclosures to make.

    The study had support from Danone Research.

    Bleasdale made no disclosures.


  • October 02, 2017 12:05 PM | Ashley Monson (Administrator)

    Julia Haskins

    Exposure to extreme heat may lead to problems with pregnancy and birth outcomes, a recent study finds.

    According to the study, published in July in the International Journal of Environmental Research and Public Health, exposing pregnant women to extreme temperatures can lead to problems related to length of gestation and birthweight, neonatal stress and stillbirth.

    Study researchers conducted a literature review of the effect on climate change on maternal, fetal and neonatal health. They found evidence of adverse outcomes across studies, with preterm birth being the most common.

    Exceeding a heat threshold was found to be a bigger driver of adverse outcomes than duration of heat exposure. According to the study, “data show that surpassing historical temperature percentiles in each city resulted in an adverse birth outcome of some kind across all studies.”

    Pregnant women need to be concerned about heat exposure, said study author Sabrina McCormick, PhD, associate professor of environmental and occupational health at the Milken Institute School of Public Health at the George Washington University.

    “We often normalize the heat...but when it comes to pregnant women, it may be that we need to be more cautious than we have to date,” McCormick told The Nation’s Health. “(We need) to reconceptualize heat as another risk that pregnant women have to consider as they go about their day-to-day activities.”

    Climate change has been linked to increasing temperatures around the globe, and 2016 was the warmest year ever recorded.

    McCormick said she would like to see health care providers become more educated about extreme heat linked to climate change and communicate the dangers of extreme heat exposure with pregnant patients in regular conversations.

    Environmental policy also has the potential to influence the health outcomes of pregnant women, particularly in terms of reducing the urban heat island effect, McCormick said. The urban heat island effect refers to metropolitan areas that are much warmer than surrounding rural areas due to human activity and the absence of green spaces.

    “It’s extremely important that both policymakers and individual cities...attempt to reduce the urban heat island effect through increasing access to green space and green coverage in general,” she said.

    Public health has an equally important role in communicating the importance of staying cool in high temperatures. McCormick noted that while heat advisories are often geared toward at-risk groups such as children and elderly people, pregnant women are rarely included in such messaging. She said she would like to see public health warnings about extreme heat specifically target pregnant women, who are also at high risk for heat-related illness.

    In addition, because pregnancy is often a time for women to reconsider their health behaviors, being more environmentally conscious can also be part of making good prenatal health decisions, according to McCormick.

    “When we think about the transgenerational effects of climate change — which there are and there will be more of — this kind of research shows how (what) we’re doing today will affect our children (and) our children’s children,” she said. “It’s an important reflection on why we need to be taking action.”

    For more information, visit http://www.mdpi.com/1660-4601/14/8/853/htm.


  • October 02, 2017 7:40 AM | Ashley Monson (Administrator)

    Women: Take five! Or less! Learn about five things you can do that can go a long way to improve or maintain good health.

    In Five Minutes or Less, You Can:

    1. Learn about the number one killer of women.
      Heart disease is the leading cause of death for women in the United States. Learn the symptoms of a heart attack and stroke. You can save a life by knowing the signs and symptoms!
    2. Schedule a check-up. 
      Regular check-ups are important. Schedule an appointment with your health care provider to discuss what screenings and exams you need and when you need them.
    3. Protect your skin from the sun. 
      Skin cancer is one of the most common cancers among women in the United States. In just minutes you can protect your skin and put on broad spectrum sunscreen with at least SPF 15 before you go outside, even on slightly cloudy or cool days.
    4. Find an HIV, STD, and Hepatitis testing site near you. 
      Untreated sexually transmitted diseases (STDs) can have long-term consequences [221 KB] for women, such as infertility. Find testing near you to know your status.
    5. Take folic acid before and during pregnancy.
      The B vitamin folic acid can help prevent certain birth defects. If a woman has enough folic acid in her body before and during pregnancy, her baby may be less likely to be born with certain birth defects of the brain or spine. All women who could possibly get pregnant should take 400 micrograms of folic acid every day in a vitamin or in foods that have been enriched with it.

    These tips are just a few of the many things you can do in five minutes or less. Learn more small steps you can take to improve your health.


  • September 28, 2017 8:39 AM | Ashley Monson (Administrator)


    Annual report shows more than 2 million cases of chlamydia, gonorrhea and syphilis reported in 2016

    En Español

    TUESDAY, Sept. 26, 2017 (HealthDay News) -- New cases of sexually transmitted diseases in the United States reached an all-time high in 2016, federal health officials reported Tuesday.

    There were 1.6 million cases of chlamydia, 470,000 cases of gonorrhea and 28,000 of syphilis reported that year, the U.S. Centers for Disease Control and Prevention announced in its annual report on STDs.

    And the diseases are on the rise in a number of groups, including women, infants, and gay and bisexual men.

    "Increases in STDs are a clear warning of a growing threat," said Dr. Jonathan Mermin, director of the CDC's National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention.

    "STDs are a persistent enemy, growing in number, and outpacing our ability to respond," he said in an agency news release.

    Young women account for nearly half of all diagnosed chlamydia infections, but syphilis and gonorrhea are increasingly affecting new groups of people.

    Between 2015 and 2016, syphilis rates rose nearly 18 percent. Most cases occurred among men, especially gays and bisexuals. Half of the men in those two groups also had HIV, according to the report.

    But syphilis rates rose 36 percent among women and 28 percent among newborns between 2015 and 2016. In 2016, there were more than 600 cases of syphilis-infected newborns, resulting in more than 40 deaths and severe health complications, the CDC said.

    "Every baby born with syphilis represents a tragic systems failure," said Gail Bolan, director of CDC's Division of STD Prevention. "All it takes is a simple STD test and antibiotic treatment to prevent this enormous heartache and help assure a healthy start for the next generation of Americans."

    Gonorrhea rates rose among both men and women in 2016, but the largest increase (22 percent) was among men, and a large number of new gonorrhea cases were among gay and bisexual men. The report also noted the growing threat of drug resistance to the last remaining recommended gonorrhea treatment.

    In order to stem the rise in STD rates, the CDC said:

    • State and local health departments need to refocus on preventing and treating these diseases.
    • Doctors need to make STD screening and treatment a standard part of medical care, especially for pregnant women and gay and bisexual men.
    • People need to talk openly about STDs, get tested regularly, and reduce risk by using condoms or being monogamous.

    Antibiotics can cure all three diseases. But if undiagnosed and untreated, STDs can lead to serious health problems such as infertility, life-threatening ectopic pregnancy, stillbirth, and increased risk of HIV infection, according to the CDC.

    More information

    The U.S. National Institute of Allergy and Infectious Diseases has more on STDs.

    SOURCE: U.S. Centers for Disease Control and Prevention, news release, Sept. 26, 2017

    -- Robert Preidt

    Last Updated: Sep 26, 2017

    Copyright © 2017 HealthDay. All rights reserved.


  • September 28, 2017 7:48 AM | Ashley Monson (Administrator)

    Mood disorder seen in 1 in 200 new moms with no psychiatric history

    En Español

    By Dennis Thompson
    HealthDay Reporter

    TUESDAY, Sept. 26, 2017 (HealthDay News) -- Women who have suffered from postpartum depression are more likely to go through it again after subsequent pregnancies, a new Danish study shows.

    Postpartum depression occurs 27 to 46 times more frequently during subsequent pregnancies for mothers who experienced it after their first birth, researchers report.

    These results show that women who have had postpartum depression in the past should prepare themselves if they get pregnant again, said lead researcher Marie-Louise Rasmussen, an epidemiologist with Statens Serum Institut in Copenhagen.

    Antidepressants or psychotherapy could help cushion the blow or even head off postpartum depression, Rasmussen said.

    "In theory, psychotherapy is preferred but not always sufficient and not always available. Often, the general practitioner has to add antidepressant medication," Rasmussen said. "Social support from the spouse and surroundings is also very important."

    In most cases, women can expect to shake off their postpartum depression within a year, the researchers found.

    "Based on this data, we would think for most women who receive treatment, their depression should be treated and resolved in six months or less," said Dr. James Murrough. He's director of the mood and anxiety disorders program at the Icahn School of Medicine at Mount Sinai in New York City.

    Postpartum depression generally takes hold of a new mother within days of delivery, although sometimes depression develops during pregnancy, according to the U.S. National Institute of Mental Health.

    Brain chemistry changes caused by post-delivery hormone fluctuations are a contributing cause of postpartum depression, along with the sleep deprivation experienced by most new parents, NIMH says.

    Signs of postpartum depression can include feelings of sadness and hopelessness, frequent crying, anxiety or moodiness, changes in sleeping or eating patterns, difficulty with concentration, anger or rage, and loss of interest in activities that are usually enjoyable, according to the mental health institute.

    A new mother with postpartum depression also might withdraw from friends or family and have difficulty forming an emotional attachment to her baby.

    Rasmussen and her colleagues undertook this study to provide women facing pregnancy with better estimates of their overall risk of postpartum depression.

    "Postpartum depression is a disease depriving families of a time period that should be filled with affinity, love and bonding," Rasmussen said. "Especially for women with no prior experience with psychiatric disease, this must come as a bolt out of the blue."

    The researchers analyzed data from Danish national registries on more than 457,000 women who delivered their first child between 1996 and 2013 and had no prior medical history of depression.

    They reviewed medical records for signs of postpartum depression -- specifically whether these women filled an antidepressant prescription or sought treatment for depression within six months after giving birth.

    About 1 in every 200 women experienced postpartum depression, the researchers found.

    But within a year of seeking care, only 28 percent of these women were still being treated for depression, the results showed. And four years later, that number was 5 percent.

    The risk of postpartum depression in subsequent births was 15 percent for women who took antidepressants following their first birth and 21 percent for women who sought depression treatment at a hospital. That amounts to a 27 and 46 times higher risk than for women who didn't experience depression during their first pregnancy, the researchers said.

    "The episodes were characterized by a relatively short treatment duration, yet a notably higher rate of later depression and recurrent episodes of postpartum depression," Rasmussen said.

    The higher risk for women who've already experienced postpartum depression "suggests that there's some underlying vulnerability to develop depression in these particular individuals," Murrough said. "Basically, it's not random. If you had it before, you could have it again."

    Murrough and Rasmussen urged pregnant women to discuss the risk of postpartum depression with their doctor, particularly if they suffered it before.

    "It's not clear that's discussed often in standard practice, amazingly," Murrough said.

    The new study was published Sept. 26 in the journal PLOS Medicine.

    More information

    For more on postpartum depression, visit the U.S. National Institute of Mental Health.

    SOURCES: Marie-Louise Rasmussen, epidemiologist, Statens Serum Institut, Copenhagen, Denmark; James Murrough, M.D., director, Mood and Anxiety Disorders Program, Icahn School of Medicine at Mount Sinai, New York City; Sept. 26, 2017, PLOS Medicine

    Last Updated: Sep 26, 2017

    Copyright © 2017 HealthDay. All rights reserved.


  • September 21, 2017 9:15 AM | Ashley Monson (Administrator)
    Original article 

    by 
    Jeff Minerd, Contributing Writer, MedPage TodaySeptember 20, 2017

    Action Points

    A prophylactic, postoperative course of antibiotics with cephalexin (Keflex) and metronidazole (Flagyl) reduced rates of surgical site infection (SSI) in obese women undergoing cesarean delivery, a randomized clinical trial found.

    Thirty days after C-section delivery, the rate of SSI was 6.4% in the treatment group versus 15.4% in the placebo group (between group difference 9%, 95% CI 2.9%-15%, P=0.01), reported Carri Warshak, MD, of the University of Cincinnati College of Medicine in Ohio, and colleagues.

    The relative risk of SSI was reduced by 59% in the treatment group versus the placebo group (RR 0.41, 95% CI 0.22-0.77, P=0.01), they wrote in the Journal of the American Medical Association.

    C-section deliveries are the most frequently performed surgeries in the U.S., Warshak's group said. Approximately 1.3 million were performed in 2010. Previous research has shown that 3% to 12% of all C-section deliveries are complicated by surgical site infections, and that infection risk increases with increasing maternal weight, they said.

    "Obesity is an independent risk factor for SSI despite recommended preoperative antibiotic regimens. Limited studies have addressed optimal antibiotic regimens for the prevention of SSI among obese women," the investigators wrote. "Various postpartum antibiotic combinations and durations have been studied with conflicting benefit, but no studies have specifically addressed the obese population.

    "This study was the first to our knowledge to evaluate the use of a prophylactic postcesarean course of cephalexin-metronidazole for prevention of SSI in an obese population," they said. "Cephalexin and metronidazole have high oral bioavailability and pharmacoeconomic advantages and are generally well tolerated, supporting the drug combination as a choice for postpartum prophylactic coverage."

    Anatomic factors associated with obesity, such as skin folds and increased tissue pressure, or the bioactive qualities of adipose tissue, which secretes hormones, chemokines, and cytokines, may be why obesity increases SSI risk, the investigators said.

    The single-center, double-blind study enrolled 403 pregnant women with a BMI≥ 30 and a final plan for C-section delivery. They were enrolled from October 2010 through December 2015 and followed through February 2016. Their mean age was 28 and mean BMI was 39.7.

    Study participants were randomly assigned to receive oral cephalexin, 500mg, and metronidazole, 500mg (n=202), versus an identical-appearing placebo (n=201) every 8 hours for a total of 48 hours following C-section delivery. The primary outcome was SSI, defined as any superficial incisional, deep incisional, or organ/space infections within 30 days after C-section delivery.

    All participants received 2 g of intravenous cefazolin (Ancef, Kefzol) prior to surgery, which was the standard of care at the time of the study. The overall SSI rate in the study was 10.9% (95% CI 7.9%-14%). No serious adverse events were reported in the treatment or placebo groups, the investigators said.

    Cellulitis was the only secondary outcome significantly reduced with prophylactic antibiotics, Warshak's group reported. Cellulitis occurred in 12 participants in the treatment group (5.9%, 95% CI 2.7%-9.2%) versus 27 in the placebo group (13.4%, 95% CI 8.9%-18.2%). The mean difference was 7.5% (95% CI 1.7%-13.0%). The relative risk was 0.44 (95% CI 0.23-0.84). There were no significant differences between treatment and placebo for other secondary outcomes, including rates of incisional morbidity, fever of unknown etiology, wound separation, or endometritis.

    In an accompanying editorial, David Calfee, MD, and Amos Grünebaum, MD, both of Weill Cornell Medicine in New York City, agreed with the authors' conclusions. "The results of this study suggest that a 2-day course of oral cephalexin and metronidazole after cesarean delivery may be an effective strategy to prevent postcesarean SSI among obese women," they wrote.

    However, Calfee and Grünebaum added several caveats. "When determining if and how the results of this study should alter current clinical practice, it is important to recognize that the results of this study are quite different from those of several previous studies conducted in other surgical patient populations in which no benefit from postoperative antimicrobial prophylaxis was found and on which current clinical guidelines for antimicrobial prophylaxis are based," they wrote. "The explanation for this difference may be as simple as the identification in the current study of a very specific, high-risk group of patients for which the intervention is effective."

    "However, several questions are worthy of additional consideration and study," they said. "For example, were glycemic control, maintenance of normothermia, and preoperative bathing routinely implemented? Would the same benefit be seen among obese women who receive a higher preoperative dose of cefazolin (ie, 3 g), as recommended in current clinical practice guidelines?"

    Both the editorialists and the authors said a chief study limitation was its single-center design, which raises the possibility of site-specific confounders, so that the results might not be generalizable to other obstetric practices.

    The study was funded by the University of Cincinnati Department of Obstetrics and Gynecology.

    Warshak and co-authors disclosed no relevant relationships with industry.

    Calfee disclosed support from Merck, Sharpe, and Dohme.

    • Reviewed by Robert Jasmer, MD Associate Clinical Professor of Medicine, University of California, San Francisco and Dorothy Caputo, MA, BSN, RN, Nurse Planner
  • September 08, 2017 8:42 AM | Ashley Monson (Administrator)

    AAPA
    Apply by Sept. 15 to be considered for a partial scholarship to the Leadership Academy for PAs, a six-month professional development certificate program in leadership. Brought to you by the AAPA Center for Healthcare Leadership and Management and Arizona State University's College of Health Solutions, the Leadership Academy is an optional add-on to the Executive Leadership Conference for PAs (ELC). Register for ELC and the Leadership Academy today!

  • September 07, 2017 4:00 PM | Ashley Monson (Administrator)

    OB/GYN Physician Assistant

    September 07, 2017 3:55 PM | Ashley Monson

    Organization: Cambridge Health Alliance
    Position: OB/GYN Physician Assistant
    Location: Cambridge, Massachusetts (Boston)
    Date Posted: 09/07/2017

    www.chaproviders.org

    Cambridge Health Alliance (CHA) is a well respected, nationally recognized and award-winning public healthcare system, which receives recognition for clinical and academic innovations. We have an excellent opportunity for a qualified Physician Assistant to join our OB/GYN team. Our system is comprised of three campuses and an integrated network of both primary and specialty care practices in Cambridge, Somerville and Boston’s Metro North Region. CHA is a teaching affiliate of both Harvard Medical School (HMS) and Tufts University School of Medicine.


    View more

  • September 05, 2017 12:03 PM | Ashley Monson (Administrator)

    Rubin KH, et al. Clin Endocrinol Metab. 2017;doi:10.1210/jc.2017-01354.

    August 31, 2017

    Women with polycystic ovary syndrome are four times more likely to develop type 2 diabetes compared with women without the syndrome, and the increased risk may be associated with BMI, insulin and glucose levels, according to a study of women in Denmark.

    “Many women with PCOS are obese, but the risk for the development of diabetes in PCOS is unknown,” Dorte Glintborg, MD, PhD, of the department of endocrinology at Odense University Hospital, said in a press release. “In this study, we found that the risk of developing diabetes is four times greater and that diabetes is diagnosed 4 years earlier in women with PCOS compared to controls.”

    Glintborg and colleagues evaluated data on women with PCOS from the National Patient Register (PCOS Denmark; n = 18,477) including a subgroup of women with PCOS examined at Odense University Hospital, as well as three age-matched controls per participant (n = 54,680). Researchers sought to determine the risk for development of type 2 diabetes in women with PCOS and whether age, number of births and prescriptions for oral contraceptives modify the effects. Median follow-up was 11.1 years.

    Participants in PCOS Denmark were more likely to develop type 2 diabetes than controls (HR = 4; 95% CI, 3.7-4.3), and the risk remained elevated when gestational diabetes was excluded from analysis (HR = 3.5; 95% CI, 3.2-3.8).

    Prescriptions for oral contraceptives were associated with a higher risk for type 2 diabetes (HR = 1.4; 95% CI, 1.3-1.6); however, oral contraceptives were not associated with type 2 diabetes when gestational diabetes was excluded from the analysis. The risk for type 2 diabetes was decreased with higher numbers of births.

    Participants in PCOS Denmark were younger than controls at type 2 diabetes diagnosis (median age, 31 years vs. 35 years; < .001); similarly, more participants were younger than 40 years in PCOS Denmark compared with controls (82% vs. 66%; < .001).

    Compared with controls who developed type 2 diabetes, participants in PCOS Denmark who developed diabetes had a lower prevalence of oral contraceptive prescriptions, higher prevalence of metformin prescriptions and a lower number of births.

    BMI, HbA1c, fasting blood glucose, 2-hour blood glucose, homeostasis model assessment of insulin resistance and triglyceride values were positively associated with type 2 diabetes development in multiple regression analyses.

    “The increased risk of developing [type 2 diabetes] in PCOS is an important finding,” Glintborg said. “Diabetes may develop at a young age, and screening for diabetes is important, especially in women who are obese and have PCOS.” – by Amber Cox

    Disclosures: The authors report no relevant financial disclosures.


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