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March 24, 2023

Gut microbes may help doctors diagnose gestational diabetes earlier in pregnancy, study finds

Identifying – and treating – the condition sooner may reduce complications for mothers and their babies

Women's Health Diabetes
Gestational Diabetes Pregnancy Daniel Reche/Pixabay

Doctors may be able to diagnose gestational diabetes in the first trimester of pregnancy by examining the gut microbes of their patients, reducing the risk of pregnancy complications, a new study suggests.

Gestational diabetes is usually diagnosed in the second or third trimester of pregnancy. But a new study suggests that it may be possible to diagnose it during the first trimester by examining gut microbes, thereby reducing potential complications for the mother and her unborn baby. 

About 10% of pregnant women worldwide develop gestational diabetes, a condition in which women without diabetes develop glucose intolerance until their babies are delivered.

The researchers found marked differences in the first trimester gut microbiota – the bacteria found in the intestines – of women who later develop gestational diabetes by examining fecal and blood samples. These women had higher inflammation and lower levels of good metabolites – any substance produced during metabolism that is beneficial to one's health. 

The researchers were able to use the information they gathered to predict which women would develop gestational diabetes. 

"Recognition of women at risk of gestational diabetes at an early stage of pregnancy may allow specific recommendations for prevention of the disease – currently by lifestyle modification and in the future perhaps by specific pre, pro, and postbiotic supplementation," said Omry Koren, of Bar-Ilan University in Israel. 

Gestational diabetes: Symptoms, treatment and risk factors

Women with gestational diabetes cannot make enough insulin, a hormone needed to control blood sugar levels. 

Sometimes the normal changes that occur during pregnancy, such as weight gain and elevated hormone levels, can cause the body to use insulin less effectively. This is called insulin resistance. When this happens the body needs more insulin to function properly.

Most women have some insulin resistance at the late stages of pregnancy, but women who have insulin resistance before they get pregnant are more at risk for developing gestational diabetes.

There are not many symptoms associated with gestational diabetes, but some women experience increased thirst and more frequent urination. Testing for gestational diabetes is a regular part of prenatal care. Proper management of the condition is important for the health of the mother and her baby. 

Women who are diagnosed with gestational diabetes are advised to follow a healthy eating and plan and to get regular exercise to lower their blood sugar levels and reduce insulin intolerance. Doctors will offer recommendations on the appropriate form of physical activity. In some cases, doctors may prescribe medication to help women control their blood sugar levels.  

Risk factors for gestational diabetes include being overweight or obese, a family history of diabetes and having prediabetes or polycystic ovary syndrome. Women who have had gestational diabetes during a prior pregnancy or delivered a baby weighing more than 9 pounds also have higher risk. The condition is more prevalent among Black, Hispanic, Asian and indigenous women. 

Though blood sugar levels usually returns to normal after pregnancy, about 50% of women with gestational diabetes later develop type 2 diabetes. Reaching a healthy body weight after delivery can help reduce the risk of type 2 diabetes. Women who develop gestational diabetes are advised to have their blood sugar levels tested six to 12 weeks after their babies are born, and then every 1-3 years afterward. 

Women with gestational diabetes are more likely to develop high blood pressure during pregnancy, which could lead to preeclampsia. They also have an increased risk of having a large baby and needing a Cesarean section.

Babies born to women with gestational diabetes are more likely to be born early, incur injuries during childbirth and have low blood sugar levels. Preterm birth can cause various complications, including difficulty breathing. These babies also have an increased risk of developing type 2 diabetes. 

The best way to prevent gestational diabetes is to lose weight before getting pregnant, if overweight, and to exercise regularly during pregnancy. Once pregnant, women should not try to lose weight, but instead try limit weight gain to the amount needed to ensure a healthy baby. 

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