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

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

    Dr Sara White, Dr Angela Flynn, Professor Lucilla Poston

    Start date: 2020
    End date: 2023

This project took place at our London centre which operated between 1995 and 2021.

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.

Giving diet and exercise advice or medication to obese women early in pregnancy has so far not been shown to prevent gestational diabetes. 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?

By looking at data from the UPBEAT study, researchers funded by Tommy’s have developed a simple tool that uses the results of a blood test, along with age, blood pressure and 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, which is given at 24 to 28 weeks.

In this pilot study, the risk assessment tool will be used to identify women at high risk (1 in 2 chance) of developing gestational diabetes. These women will then be given either lifestyle advice, lifestyle advice plus the anti-diabetic drug metformin, or standard antenatal care. Our researchers hope that 84 women will take part in the study.

The team will assess the impact of these options on the women’s blood sugar levels and metabolism, as well as their diet and physical activity levels. If successful, the results from this pilot study should give our researchers the evidence they need to set up larger trials that can definitively test how effective these methods are at preventing diabetes in pregnancy.

What difference will this project make?

Too often, preventative treatment for gestational diabetes is given too late or to people who are less likely to develop the condition. Our researchers hope this project will show that early intervention can be effective when it is targeted towards the obese women who are most at risk of developing gestational diabetes. This work could eventually lead to these women getting the support they need early in pregnancy, therefore reducing the health risks for them and their babies.

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