Predicting gestational diabetes in obese pregnant women

Professor Lucilla Poston, Sara L White, Sir George Alberti, Dr Annette Briley, Dr Shahrad Taheri, the UPBEAT Consortium

Researchers are looking at whether a simple test early on in pregnancy can identify women at risk of diabetes.

Obesity is known to increase the risk of developing diabetes in pregnancy. Currently, 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

We want to find a way to identify women who are at high risk to allow resources for treatment to be used on those who will benefit the most. 

Gestational diabetes is diagnosed between 24 and 28 weeks of pregnancy using an oral glucose tolerance test (OGTT). This test is recommended for all obese pregnant women. 

However, there are several drawbacks to this approach. Firstly, the OGTT is time consuming (3 hours) and women frequently fail to attend these appointments. Secondly, the test is taken too late in pregnancy as it is now known that changes to the metabolism and excessive fetal growth are already established before the 24-28 week mark. 

To address this need for an early pregnancy gestational diabetes test, we have developed a simple tool using data from the UK UPBEAT trial of 1555 women. 

It has been designed to identify those women most likely to benefit from early intervention (such as diet or tablets) to reduce the risk of diabetes for them and their babies. 

We now aim to trial the tool in settings where it is needed most; In a multi-ethnic urban population in London and in Qatar where the diagnosis of gestational diabetes is amongst the highest in the world. 

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This study is funded by Tommy's, the Qatar Department of Health and the National Research Fund of Qatar.

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