{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T20:22:57Z","timestamp":1792700577125,"version":"4.5.0"},"reference-count":36,"publisher":"Bioscientifica","issue":"1","license":[{"start":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T00:00:00Z","timestamp":1781481600000},"content-version":"vor","delay-in-days":173,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["journals.bioscientifica.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,2,1]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To compare demographical and thyroid parameters\/disorders between a group of women with gestational diabetes mellitus (GDM) treated with diet and lifestyle measures (DiLS) and a group also necessitating insulin therapy (IT). Furthermore, to determine which variables were associated with IT need.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design\/methods<\/jats:title>\n                    <jats:p>Retrospective analysis in a single centre cohort including 1,782 women screened at median 12 (11\u201314) weeks of pregnancy for thyroid disorders (TSH, free T4 (FT4), and TPOAb) and for GDM with an oral glucose tolerance test at 24\u201328 weeks. Women with assisted and multiple pregnancies were excluded (n = 85). The diagnosis of GDM was based on the 2013 WHO criteria, and TAI on increased TPOAb levels (\u226560 kIU\/L). Multivariable regression analyses were applied to identify variables\/conditions (thyroxine treatment before or after screening, thyroid parameters (TSH and FT4 levels), and thyroid disorders (subclinical hypothyroidism (SCH) and\/or thyroid autoimmunity (TAI)) were associated with IT.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Overall, 328 of the 1,697 women were diagnosed with GDM (19.3%); 54 were treated with IT (16.5%) and 274 only with diet and lifestyle measures (83.5%). After adjustment for confounders, only FT4 levels were associated with IT need (adjusted odds ratio: 0.76; 95% CI: 0.61\u20130.94; P = 0.011).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Lower serum free T4 levels were independently associated with a higher risk for IT need in women with GDM. More research is needed to unravel this association, but insulin resistance is probably a major contributor.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1530\/etj-25-0206","type":"journal-article","created":{"date-parts":[[2025,12,24]],"date-time":"2025-12-24T12:36:54Z","timestamp":1766579814000},"update-policy":"https:\/\/doi.org\/10.1530\/crossmarkpolicy-17","source":"Crossref","is-referenced-by-count":3,"title":["Low FT4 levels in early pregnancy are associated with higher insulin therapy need in women with gestational diabetes mellitus"],"prefix":"10.1530","volume":"15","author":[{"given":"Emna","family":"Jelloul","sequence":"first","affiliation":[{"name":"1"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manon","family":"Lomr\u00e9","sequence":"additional","affiliation":[{"name":"1"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierre","family":"Kleynen","sequence":"additional","affiliation":[{"name":"1"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georgiana","family":"Sitoris","sequence":"additional","affiliation":[{"name":"1"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lidia","family":"Grabczan","sequence":"additional","affiliation":[{"name":"1"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Flora","family":"Veltri","sequence":"additional","affiliation":[{"name":"1"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Madhu","family":"Prasai","sequence":"additional","affiliation":[{"name":"1"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Serge","family":"Rozenberg","sequence":"additional","affiliation":[{"name":"2"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5452-4243","authenticated-orcid":true,"given":"Kris G","family":"Poppe","sequence":"additional","affiliation":[{"name":"1"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"416","published-online":{"date-parts":[[2025,12,24]]},"reference":[{"key":"2026070714084187600_bib1","doi-asserted-by":"crossref","first-page":"763","DOI":"10.1210\/endrev\/bnac003","article-title":"A clinical update on gestational diabetes mellitus","volume":"43","author":"Sweeting","year":"2022","journal-title":"Endocr Rev"},{"key":"2026070714084187600_bib2","doi-asserted-by":"crossref","first-page":"610","DOI":"10.1038\/nrendo.2017.93","article-title":"Thyroid disease in pregnancy: new insights in diagnosis and clinical management","volume":"13","author":"Korevaar","year":"2017","journal-title":"Nat Rev Endocrinol"},{"key":"2026070714084187600_bib3","doi-asserted-by":"crossref","first-page":"789","DOI":"10.1210\/er.2018-00163","article-title":"Thyroid dysfunction and diabetes mellitus: two closely associated disorders","volume":"40","author":"Biondi","year":"2019","journal-title":"Endocr Rev"},{"key":"2026070714084187600_bib4","doi-asserted-by":"crossref","first-page":"550","DOI":"10.1007\/s12020-021-02712-2","article-title":"Association of thyroid disorders with gestational diabetes mellitus: a meta-analysis","volume":"73","author":"Luo","year":"2021","journal-title":"Endocrine"},{"key":"2026070714084187600_bib5","doi-asserted-by":"crossref","first-page":"S306","DOI":"10.2337\/dc25-S015","article-title":"15. 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