New blood test could predict gestational diabetes
Researchers say they may have discovered a new way to predict glucose intolerance in pregnancy using a diabetes biomarker.
The team from Brigham and Women’s Hospital (BWH) in Boston say the answer lies in plasma glycated CD59 (pGCD59), measurements which has found to be a strong predictor of glucose problems in expectant women.
They studied 1,000 plasma samples from pregnant women receiving standard prenatal care. Half of the expectant mothers had a normal glucose challenge test (GCT) for screening of gestational diabetes (GDM).
The other 500 had a failed GCT and had a subsequent oral glucose tolerance test. The researchers discovered those women with gestational diabetes mellitus (GDM) had a 10-fold higher median pGCD59 value at 3.23, while others had an 8.5-fold higher value of the biomarker at 0.33 compared with the controlled people at 0.33 (0.92 area under the receiver characteristic operating curve, P<0.001).
Senior study author Dr Jose Halperin, who is director of the hematology laboratory for translational research at BWH, said: “This is the first study to demonstrate that a single measurement of plasma GCD59 can be used as a simplified method to identify women who are at risk for failing the glucose challenge test and are at higher risk for developing gestational diabetes.”
These results suggest that a single measurement of plasma GCD59 during weeks 24–28 may also help stratify the risk for delivering larger infants among women with gestational glucose intolerance
The researchers also found that higher plasma GCD59 levels at gestational week 24-28 were associated with higher prevalence of large-for-gestational-age newborns, with the higher the level, the higher the risk (4 per cent higher risk for women in the lowest quartile of GCD59 plasma levels, and 14 per cent in the highest quartile).
Out of the 58 large-for-gestational-age babies born to mothers that failed the glucose challenge test in this study, 80 per cent were born to mothers who did not meet oral glucose tolerance test criteria for gestational diabetes, but had median plasma GCD59 levels 7-fold higher than control women with a normal glucose challenge test.
These findings are consistent with other studies showing that women who fail the glucose challenge test, but do not meet criteria for gestational diabetes, are still at a higher risk of abnormal pregnancy outcomes, including delivering large for gestational age babies.
Currently there are no practice guidelines for the management of women who fall between normal and abnormal glucose tolerance levels, and, therefore, their management is the same as that for women with a normal glucose challenge test results.
Dr Halperin. added: “These results suggest that a single measurement of plasma GCD59 during weeks 24–28 may also help stratify the risk for delivering larger infants among women with gestational glucose intolerance.
“Our studies opened an avenue for larger multicenter studies to further assess the clinical utility of plasma GCD59 for screening and diagnosis of gestational diabetes among the general population of the United States. If our results are confirmed, we’re hopeful that the GCD59 test could be available in clinical practices within the next few years.”
The findings have been published in the journal Diabetes Care.