News in brief: Metformin-exposed babies are different; Reduced injection frequency of Diphereline a small comfort for children; Doctors turn to drink to relieve pandemic distress

Metformin-exposed babies are different

Infants whose mothers take metformin for hyperglycaemia in pregnancy show subtle nonpathological metabolic differences that represent a ‘signature effect’ of fetal metformin exposure, Australian researchers say.

A team from Western Sydney University and Blacktown hospital compared neonatal screening results for 574 babies exposed to metformin and 952 infants of women who had hyperglycaemia treated with diet and a control group of 979 matched infants.

Metformin-exposed infants had shorter gestational age (266  vs. 272 vs. 274 days) and lower birth weights (3.28 vs. 3.29 vs. 3.33 kg), according to findings published in Diabetes Care.

Metformin-exposed infants had higher concentrations of short-, medium-, and one long-chain acylcarntine compared with normal control subjects. And to eliminate confounding by hyperglycemia, a comparison with diet-treated control subjects with diabetes continued to show raised butyrylcarnitine (C4), isovalerylcarnitine (C5), and glutarylcarnitine (C5D) in the metformin-exposed group.

There was no evidence of vitamin B12 deficiency (low methionine and elevated propionylcarnitine [C3]) in metformin-exposed infants, and all results were within normal population limits, the researchers noted.

Reduced injection frequency of Diphereline a small comfort for children

The TGA has approved the first six-month formulation of triptorelin embonate (Diphereline) for use in girls 2-8 years and boys 2-9 years diagnosed with central precocious puberty.

Brisbane paediatric endocrinologist Associate Professor Tony Huynh said in a statement from Ipsen that the reduced injection frequency should improve the comfort of children with central precocious puberty and their compliance with treatment.

“The approval of Diphereline 22.5mg for use in CPP provides a new option to not only manage the condition but also to manage what can often be uncomfortable consultations for children.”

“Many patients are also co-shared with GPs and any streamlining of visits within and between clinics will help to assist the delicate management of these very young patients and their families.”

A Patient Familiarisation Program (PFP) will be made available for eligible patients while the PBAC considers an application for PBS listing of the gonadotropin-releasing hormone agonist.

Doctors turn to drink to relieve pandemic distress

Alcohol is one of the main coping strategies used by Australian healthcare workers in response to the pandemic, a national survey has revealed.

Conducted in September 2020, the survey on wellbeing and coping strategies elicited responses from 7846 frontline healthcare workers including more than 2400 medical staff, and showed that over a quarter (26.3%) reported increased alcohol use.

The most commonly reported adaptive coping strategies were exercise (45%), social connections (32%) and yoga or meditation (26%), whereas few used workplace support programs (6%) or sought help from a doctor or psychologist (18%).

Use of alcohol was associated with poor mental health and worse personal relationships, the study found.

The study investigators said the widespread use of maladaptive coping strategies by healthcare workers during the second wave highlighted an urgent need to improve access and uptake of professional support services for psychological distress.

Read more in General Hospital Psychiatry

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