Reviewer ’s report  
 
Title: Evaluating the role of race and medication in protection of uterine fibroids by type 2 
diabetes exposure  
 
Version: 0 Date: 17 Nov 2016  
 
Reviewer: ELIZABETH (EBBIE) A . STEWART  
 
Reviewer's report:  
 
The manuscript by Velez Edwards assesses an important question: the interaction of race, 
diabetes and uterine fibroids.  
The methods are innovative and the conclusions are supported by the data. My key concern 
regards two key confounders to this association: polycystic ovarian syndrome (PCOS) and 
gestational diabetes.  
For the first, the authors reference the prior association of PCOS and uterine fibroids, but don't 
attempt to control or adjust for this diagnosis.  Secondly it appears that there may be 
misclassification in their study of women with gestational diabetes w ho are mistakenly given a 
diagnosis of Type II diabetes. These may be overrepresented in the group treated with insulin 
rather than an oral agent. The fact that much of the ultrasound data comes during pregnancy, 
suggests that this could be an issue.  
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
Yes 
 
Does the work include the necessary controls?  
If not, please specify which  controls are required in your comments to the authors.  
 
Yes 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
Yes 
 
Are you able to assess any statistics in the manuscript or would you r ecommend an  
additional statistical review?  
If an additional statistical review is recommended, please specify what aspects require further  
assessment in your comments to the editors.  
 
I am able to assess the statistics  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Acceptable  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five years received reimbursements, fees, funding, or salary from an  
organisation that may in any way gain or lose financially from the publication of this  
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in an organisation that may in any way gain or lose  
financi ally from the publication of this manuscript, either now or in the future?  
 
3. Do you hold or are you currently applying for any patents relating to the content of the  
manuscript?  
 
4. Have you received reimbursements, fees, funding, or salary from an organiz ation that 
holds  or has applied for patents relating to the content of the manuscript?  
 
5. Do you have any other financial competing interests?  
 
6. Do you have any non -financial competing interests in relation to this paper?  
 
If you can answer no to all of th e above, write 'I declare that I have no competing interests' 
below.  If your reply is yes to any, please give details below.  
 
I declare that I have no competing interests.  
 
I agree to the open peer review policy of the journal. I understand that my name will  be included  
on my report to the authors and, if the manuscript is accepted for publication, my named report  
including any attachments I upload will be posted on the website along with the authors'  
responses. I agree for my report to be made available unde r an Open Access Creative Commons  
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments  
which I do not wish to be included in my named report can be included as confidential comments  
to the editors, which will not be p ublished.  
 
I agree to the open peer review policy of the journal