Predicting gestational diabetes in obese pregnant women

Prof Lucilla Poston, Dr Sara White, Mr Paul Seed, Dr Annette Briley, Dr Angela Flynn, Dr Dharmintra Pasupathy, Jessamine Hunt, Dr Claire Singh, Janelle Phillips, Dr Carolyn Gill, Ms Anna Brockbank, Ms Ana Brennand

Gestational diabetes can carry risks for both mother and baby. Our researchers are looking at whether a test in early pregnancy can identify women at risk of developing diabetes, ensuring that they get the support they need as soon as possible.

Start date: 2018

End date: 2020

Why do we need this research?

Obesity is known to increase the risk of developing diabetes in pregnancy, known as gestational diabetes. It can lead to problems such as the baby growing too fast in the womb, and can increase the chances of stillbirth. But right now, all obese women are considered to be at high risk, despite the fact that more than 70% of these women will be free from diabetes during pregnancy. 

Gestational diabetes is currently diagnosed between 24 and 28 weeks of pregnancy using an oral glucose tolerance test (OGTT). However, this test has two major drawbacks: firstly, the OGTT is time consuming, meaning women often aren’t able to attend the appointments. Secondly, we now know that the test is taken too late in pregnancy, because the changes to the metabolism and excessive fetal growth caused by diabetes have already started before the 24-28 week mark.

We want to find a better way to identify women who are at high risk of gestational diabetes, earlier than we’re currently able to. This will means mothers who will benefit the most get the treatment they need. 

What’s happening in this project?

To address this need for an early pregnancy gestational diabetes test, researchers supported by Tommy’s have developed a simple tool using data from the UPBEAT trial of more than 1,500 women. It has been designed to identify which obese women are most likely to benefit from early intervention (such as diet or tablets) to reduce the risk of diabetes for them and their babies. The team are now testing the tool in in a multi-ethnic urban population in London.

What difference will this project make?

This study will show whether the tool our researchers have developed can assess a woman’s risk of gestational diabetes earlier than currently possible. This could mean that women at high risk can get treatment to manage their diabetes earlier, to reduce the risk of complications for them and their baby. It’ll also mean that women who are found to be at lower risk of diabetes don’t get treatment they don’t need.

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