Study charts possibilities for a better way to diagnose gestational diabetes
- Date:
- January 4, 2024
- Source:
- Rutgers University
- Summary:
- Pregnancy weight and biochemical markers measured in blood from women with gestational diabetes mellitus (GDM) were related to increased risk of poor pregnancy outcomes, suggesting a new direction for precision diagnostics.
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Pregnancy weight and biochemical markers measured in blood from women with gestational diabetes mellitus (GDM) were related to increased risk of poor pregnancy outcomes, suggesting a new direction for precision diagnostics, according to researchers.
The study led by Ellen C. Francis, an assistant professor in the Department of Biostatistics and Epidemiology at Rutgers School of Public Health, and published in Communications Medicine, evaluated the diagnostic value of these markers before or at the time of screening for GDM, a type of diabetes that can develop during pregnancy.
"Although we found that obesity is a risk factor for offspring born larger for their gestational age, evidence suggests that the metabolic alterations that accompany obesity increase the risk of adverse outcomes," said Francis. GDM, characterized by elevated blood sugar (glucose) levels during pregnancy, is the most common metabolic condition among pregnant women and poses risks to both mother and child. While standard treatments are applied, clinical outcomes can differ among individuals.
Francis said the research demonstrates the need for a more nuanced approach to diagnose GDM, which may help improve outcomes. It is the first systematic review of the literature to assess the potential of subtypes in GDM and to examine whether nonglycemic markers could refine risk stratification. Francis said some of the literature suggested insulin profiles and triglyceride levels may serve as promising non-glucose indicators of risk.
"To really assess the clinical implications of precision diagnostics in GDM, we first need to understand if insulin resistance or higher triglycerides are causally linked to adverse outcomes, and whether we can safely target them in pregnancy," Francis said.
Overall, researchers found a critical gap in the existing literature in which most studies hadn't focused on comparing clinical, biochemical or sociocultural differences among women who develop GDM.
"In our full text screening of 775 studies, we found that only recently has there been a focus on clinical, biochemical, or sociocultural markers that could improve who is at greatest risk of poor outcomes, and on comparing clinical outcomes between different subtypes of GDM," said Francis. "The data from these studies indicate that in the future, we may be able to refine how we diagnose GDM by using anthropometric or biochemical information in combination with current diagnostic approaches."
Future research should delve into mechanistic studies on precision biomarkers, large diverse population studies for replication, and multinational studies focusing on environmental and behavioral factors, Francis said. It should also explore potential insights on casual pathways of heterogeneity within GDM and its outcomes from genetic and multi-omics data using advanced analytical approaches.
Study co-authors include researchers from collaborating institutions in the United States, the United Kingdom, Singapore, South Korea and Australia.
Story Source:
Materials provided by Rutgers University. Original written by Nakaysha Gonzalez. Note: Content may be edited for style and length.
Journal Reference:
- Ellen C. Francis, Camille E. Powe, William L. Lowe, Sara L. White, Denise M. Scholtens, Jiaxi Yang, Yeyi Zhu, Cuilin Zhang, Marie-France Hivert, Soo Heon Kwak, Arianne Sweeting, Deirdre K. Tobias, Jordi Merino, Abrar Ahmad, Catherine Aiken, Jamie L. Benham, Dhanasekaran Bodhini, Amy L. Clark, Kevin Colclough, Rosa Corcoy, Sara J. Cromer, Daisy Duan, Jamie L. Felton, Pieter Gillard, Véronique Gingras, Romy Gaillard, Eram Haider, Alice Hughes, Jennifer M. Ikle, Laura M. Jacobsen, Anna R. Kahkoska, Jarno L. T. Kettunen, Raymond J. Kreienkamp, Lee-Ling Lim, Jonna M. E. Männistö, Robert Massey, Niamh-Maire Mclennan, Rachel G. Miller, Mario Luca Morieri, Jasper Most, Rochelle N. Naylor, Bige Ozkan, Kashyap Amratlal Patel, Scott J. Pilla, Katsiaryna Prystupa, Sridharan Raghavan, Mary R. Rooney, Martin Schön, Zhila Semnani-Azad, Magdalena Sevilla-Gonzalez, Pernille Svalastoga, Wubet Worku Takele, Claudia Ha-ting Tam, Anne Cathrine B. Thuesen, Mustafa Tosur, Amelia S. Wallace, Caroline C. Wang, Jessie J. Wong, Jennifer M. Yamamoto, Katherine Young, Chloé Amouyal, Mette K. Andersen, Maxine P. Bonham, Mingling Chen, Feifei Cheng, Tinashe Chikowore, Sian C. Chivers, Christoffer Clemmensen, Dana Dabelea, Adem Y. Dawed, Aaron J. Deutsch, Laura T. Dickens, Linda A. DiMeglio, Monika Dudenhöffer-Pfeifer, Carmella Evans-Molina, María Mercè Fernández-Balsells, Hugo Fitipaldi, Stephanie L. Fitzpatrick, Stephen E. Gitelman, Mark O. Goodarzi, Jessica A. Grieger, Marta Guasch-Ferré, Nahal Habibi, Torben Hansen, Chuiguo Huang, Arianna Harris-Kawano, Heba M. Ismail, Benjamin Hoag, Randi K. Johnson, Angus G. Jones, Robert W. Koivula, Aaron Leong, Gloria K. W. Leung, Ingrid M. Libman, Kai Liu, S. Alice Long, Robert W. Morton, Ayesha A. Motala, Suna Onengut-Gumuscu, James S. Pankow, Maleesa Pathirana, Sofia Pazmino, Dianna Perez, John R. Petrie, Camille E. Powe, Alejandra Quinteros, Rashmi Jain, Debashree Ray, Mathias Ried-Larsen, Zeb Saeed, Vanessa Santhakumar, Sarah Kanbour, Sudipa Sarkar, Gabriela S. F. Monaco, Elizabeth Selvin, Wayne Huey-Herng Sheu, Cate Speake, Maggie A. Stanislawski, Nele Steenackers, Andrea K. Steck, Norbert Stefan, Julie Støy, Rachael Taylor, Sok Cin Tye, Gebresilasea Gendisha Ukke, Marzhan Urazbayeva, Bart Van der Schueren, Camille Vatier, John M. Wentworth, Wesley Hannah, Sara L. White, Gechang Yu, Yingchai Zhang, Shao J. Zhou, Jacques Beltrand, Michel Polak, Ingvild Aukrust, Elisa de Franco, Sarah E. Flanagan, Kristin A. Maloney, Andrew McGovern, Janne Molnes, Mariam Nakabuye, Pål Rasmus Njølstad, Hugo Pomares-Millan, Michele Provenzano, Cécile Saint-Martin, Cuilin Zhang, Yeyi Zhu, Sungyoung Auh, Russell de Souza, Andrea J. Fawcett, Chandra Gruber, Eskedar Getie Mekonnen, Emily Mixter, Diana Sherifali, Robert H. Eckel, John J. Nolan, Louis H. Philipson, Rebecca J. Brown, Liana K. Billings, Kristen Boyle, Tina Costacou, John M. Dennis, Jose C. Florez, Anna L. Gloyn, Maria F. Gomez, Peter A. Gottlieb, Siri Atma W. Greeley, Kurt Griffin, Andrew T. Hattersley, Irl B. Hirsch, Marie-France Hivert, Korey K. Hood, Jami L. Josefson, Lori M. Laffel, Siew S. Lim, Ruth J. F. Loos, Ronald C. W. Ma, Chantal Mathieu, Nestoras Mathioudakis, James B. Meigs, Shivani Misra, Viswanathan Mohan, Rinki Murphy, Richard Oram, Katharine R. Owen, Susan E. Ozanne, Ewan R. Pearson, Wei Perng, Toni I. Pollin, Rodica Pop-Busui, Richard E. Pratley, Leanne M. Redman, Maria J. Redondo, Rebecca M. Reynolds, Robert K. Semple, Jennifer L. Sherr, Emily K. Sims, Arianne Sweeting, Tiinamaija Tuomi, Miriam S. Udler, Kimberly K. Vesco, Tina Vilsbøll, Robert Wagner, Stephen S. Rich, Paul W. Franks. Refining the diagnosis of gestational diabetes mellitus: a systematic review and meta-analysis. Communications Medicine, 2023; 3 (1) DOI: 10.1038/s43856-023-00393-8
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