Study presents possibilities for a better way to diagnose gestational diabetes

A Rutgers professor and other researchers conducted a systematic review and meta-analysis to evaluate studies comparing perinatal outcomes in people with gestational diabetes mellitus. According to researchers, pregnancy weight and biochemical markers measured in the blood of women with gestational diabetes mellitus (GDM) were linked to an increased risk of poor pregnancy outcomes, suggesting a new direction for precision diagnostics.

The study led by Ellen C. Francis, assistant professor in the Department of Biostatistics and Epidemiology at the Rutgers School of Public Health, and published in Communication medicineevaluated 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 children born larger for their gestational age, evidence suggests that the metabolic alterations that accompany obesity increase the risk of adverse outcomes,” Francis said. . Gestational diabetes, characterized by high blood sugar (glucose) levels during pregnancy, is the most common metabolic condition in pregnant women and poses risks to both mother and child. Although standard treatments are applied, clinical results may differ between individuals.

Francis said the research demonstrates the need for a more nuanced approach to diagnosing GDM, which could help improve outcomes. This is the first systematic literature review to assess the potential of gestational diabetes subtypes and examine whether non-glycemic markers could refine risk stratification. Francis said some of the literature suggests that insulin profiles and triglyceride levels may serve as promising non-glucose risk indicators.

“To truly assess the clinical implications of precision diagnostics in GDM, we first need to understand whether insulin resistance or higher triglycerides are causally linked to adverse outcomes and whether we can safely target them. safety during pregnancy,” Francis said.

Overall, the researchers discovered a critical gap in the existing literature, in which most studies had not focused on comparing clinical, biochemical, or sociocultural differences among women who develop GDM.

“In our full-text analysis of 775 studies, we found that only recently has there been a focus on clinical, biochemical, or sociocultural markers that might improve those most at risk for poor outcomes and on comparing clinical outcomes between different subtypes of GDM,” said François. “The data from these studies indicate that in the future we may be able to refine how we diagnose GDM using anthropometric or biochemical information in combination with current diagnostic approaches.”

Future research should look at mechanistic studies of precision biomarkers, studies in large diverse populations for replication purposes, and multinational studies focusing on environmental and behavioral factors, Francis said. It is also expected to explore potential insights into occasional pathways of heterogeneity within GDM and its outcomes from genetic and multi-omics data using advanced analytical approaches.

Co-authors of the study include researchers from collaborating institutions in the United States, United Kingdom, Singapore, South Korea and Australia.