Postpartum Semaglutide to Reduce Cardiometabolic Risk After Gestational Diabetes Mellitus

This is an effectiveness‐implementation Hybrid Type 1 study using a randomized clinicaltrial design to evaluate the effectiveness and potential real‐world integration ofimmediate postpartum semaglutide following a pregnancy complicated by gestationaldiabetes mellitus (GDM). A total of 226 postpartum individuals with recent GDM will berandomized 1:1 to semaglutide or standard postpartum care for a 6‐month active treatmentphase. The primary effectiveness outcome, development of metabolic syndrome, will beassessed at 6 months postpartum. Participants will subsequently enter a 6‐monthmaintenance phase, during which semaglutide continuation, discontinuation, or initiationwill reflect patient preferences, clinical decision‐making, medication access, andinsurance coverage.