Assessing type 2 diabetes prognosis following gestational diabetes mellitus; Protocol of a systematic review comparing Insulin, oral glucose-lowering agents and diet
Bibliographic record
Abstract
Abstract 1. Background: A significant increase in the reported prevalence of gestational diabetes mellitus (GDM) has been observed. While most affected women regain normal glucose tolerance postpartum, approximately 35–60% remain at risk of developing diabetes after pregnancy (DAP) within 10–20 years. This review focuses on long-term maternal metabolic outcomes and the continuous management of GDM to prevent or delay progression to overt postpartum diabetes. 2. Objectives: Although landmark studies have demonstrated the efficacy of cornerstone interventions—insulin, metformin, and dietary therapy—comparative evidence to guide the selection of these strategies over another in specified circumstances remains limited. The objective of this protocol is to ascertain optimal therapeutic approaches for women with GDM during pregnancy and the postpartum period. 3. Methods: A comprehensive search strategy is employed using PubMed, Embase, Web of Science, Scopus, and ClinicalTrials.gov. Diabetes-focused journals and reference lists of relevant publications were also reviewed. The search includes studies published from 2000 onward. Two authors independently perform screening studies, extracting data and assessing risk of bias using Cochrane RoB 2.0 and a combination of the Newcastle–Ottawa Scale and ROBINS-I. The certainty of evidence is evaluated using GRADE. Given anticipated heterogeneity, findings will be synthesized narratively and stratified by study design. 4. Conclusions: This protocol outlines a systematic review designed to determine whether selective use of treatments during pregnancy and after delivery influences long-term risk of type 2 diabetes mellitus, with the goal of comparing postpartum prevention strategies. 5. Registration: This study protocol was developed in accordance with PRISMA-P guidance, fully registered in Zenodo and PROSPERO (ID: CRD420251039675). It is not an update of a previous protocol and has not undergone peer review.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.096 | 0.115 |
| Meta-epidemiology (narrow) | 0.005 | 0.005 |
| Meta-epidemiology (broad) | 0.020 | 0.020 |
| Bibliometrics | 0.014 | 0.013 |
| Science and technology studies | 0.004 | 0.005 |
| Scholarly communication | 0.008 | 0.007 |
| Open science | 0.007 | 0.005 |
| Research integrity | 0.008 | 0.006 |
| Insufficient payload (model declined to judge) | 0.037 | 0.006 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".