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More precise diagnostics for women with gestational diabetes are possible thanks to anthropometric or biochemical information. Researchers came to this conclusion after evaluating 775 studies.
Gestational weight and biochemical markers measured in the blood of women with gestational diabetes mellitus (GDM) were associated with an increased risk of poor pregnancy outcomes. This suggests a new direction for precision diagnostics, the researchers said. In the Communication medicine published study led by Ellen C. Francis, assistant professor in the Department of Biostatistics and Epidemiology at Rutgers School of Public Health, examined the diagnostic value of these markers before or at the time of screening for GDM.
More differentiated approach to diagnosis needed
“Although we found that obesity is a risk factor for children being born larger for their gestational age, there is evidence that the metabolic changes associated with obesity increase the risk of adverse outcomes,” Francis said. GDM, characterized by elevated blood sugar levels during pregnancy, is the most common metabolic disease in pregnant women and poses risks to mother and child. Although standard treatments are used, clinical outcomes may vary from person to person.
Francis says the study shows that a more nuanced approach to diagnosing GDM is needed to lead to better outcomes. It is the first systematic review of the literature to assess the potential of subtypes in GDM and examine whether non-glycemic markers could refine risk stratification. Francis says some of the data found in the literature suggests that insulin profiles and triglyceride levels may serve as promising non-glucose indicators of risk.
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“To truly assess the clinical impact of precision diagnostics in GDM, we must first understand whether insulin resistance or higher triglyceride levels are causally associated with adverse outcomes and whether we can safely target them in pregnancy,” Francis said.
Overall, the researchers found a critical gap in the existing literature in which most studies had not focused on comparing clinical, biochemical or sociocultural differences in women with GDM. “In our full-text screening of 775 studies, we found that only recently has there been a focus on clinical, biochemical or sociocultural markers that could ameliorate those most at risk for poor outcomes, as well as comparing clinical outcomes between different subtypes of GDM,” said Francis. “The data from these studies suggest that in the future we may be able to refine the diagnosis of GDM by using anthropometric or biochemical information in combination with current diagnostic approaches.”
The future is interdisciplinary
Future research should address mechanistic studies of precision biomarkers, large, diverse population replication studies, and multinational studies focusing on environmental and behavioral factors, Francis said. Furthermore, potential insights into the random pathways of heterogeneity within GDM and its consequences should be explored from genetic and multi-omics data using advanced analytical approaches.
This article is based on one Press release from Rutgers University. We have the original publication for you here and linked in the text.
Image source: Freestocks, Unsplash
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