Lorna Bittencourt, Dana Rubenstein, Devon Noonan, F Joseph McClernon, Dana Mowls Carroll
Smoking Quit Attempts and Associated Factors Among Rural Adults Who Smoke Daily in the US
Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco
gestational diabetes mellitus gdm heterogeneous condition given variability among patients ability recognise distinct gdm subgroups using routine clinical variables may guide personalised treatments main aim identify distinct gdm subtypes cluster analysis using routine clinical variables analyse treatment needs pregnancy outcomes across subgroups cohort study analysed datasets total 2682 women gdm treated two central european hospitals 1865 participants charit university hospital berlin 817 participants medical university vienna collected 2015 2022 evaluated various clustering models including kmeans kmedoids agglomerative hierarchical clustering internal validation techniques used guide best model selection external validation independent test sets used assess model generalisability clinical outcomes specific treatment needs maternal fetal complications analysed across identified clusters optimal model identified three clusters routinely available variables ie maternal age prepregnancy bmi bmipg glucose levels fasting 60 120 min diagnostic ogtt ogtt0 ogtt60 ogtt120 respectively cluster 1 characterised highest ogtt values obesity prevalence cluster 2 displayed intermediate bmipg elevated ogtt0 cluster 3 consisted mainly participants normal bmipg high values ogtt60 ogtt120 treatment modalities clinical outcomes varied among clusters particular cluster 1 participants showed much higher need glucoselowering medications 396 participants compared 129 100 clusters 2 3 respectively p00001 cluster 1 participants also higher risk delivering largeforgestationalage infants differences type insulinbased treatment cluster 2 cluster 3 observed external validation cohort findings confirm heterogeneity gdm identification subgroups clusters potential help clinicians define tailored treatment approaches improved maternal neonatal outcomes