Preventing diabetes in pregnancy: targeting treatment to women who are most at risk

Dr Dharmintra Pasupathy, Mr Paul Seed, Prof Lucilla Poston, Dr Sara White, Dr Angela Flynn, Dr Carolyn Gill

Our researchers are finding out whether early intervention can help prevent gestational diabetes in women most at risk.

Why do we need this research?

Women who are obese are more likely to develop diabetes in pregnancy – known as gestational diabetes – which can lead to health problems for both themselves and their baby.

Attempts to prevent gestational diabetes early in pregnancy by giving diet and exercise advice or medication do not always work. However, we now know that some obese pregnant women are more likely to develop gestational diabetes than others.

We want to see whether early treatment or advice can prevent gestational diabetes in these particularly high-risk women.

What’s happening in this project?

Researchers funded by Tommy’s have developed a simple tool based on data from the UPBEAT study. The tool uses the results of a blood test, along with age, blood pressure and upper arm circumference, to calculate a woman’s chances of developing gestational diabetes. The tool is designed to be used early in pregnancy, well before the current test for diabetes at 24 to 28 weeks.

Our researchers want to study whether focusing efforts towards women at the highest risk of diabetes, early in their pregnancy, could help to prevent the condition, and so reduce the potential health risks for mother and baby.

In this pilot study, the risk assessment tool will be used to identify women at high-risk (more than 1 in 2 chance) of developing gestational diabetes. 84 high-risk women will then be given either dietary advice, dietary advice plus the anti-diabetic drug metformin, or no treatment.

Our researchers will assess how useful the women find each option, and study the impact of these options on the women’s blood sugar levels and their metabolism. The results from this pilot study will help our researchers to set up much larger trials to properly test how effective these options are at preventing diabetes.

What difference will this project make?

Too often, preventative treatment for gestational diabetes is given too late or to people who aren’t most likely to develop the condition. Our researchers hope this project will show that targeting early interventions towards mothers at high risk is the most effective way to prevent gestational diabetes. This work could eventually mean that women most at risk of diabetes get the support they need to reduce the health risks for them and their baby.

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