Precision gestational diabetes treatment: a systematic review and meta-analyses

Benham, J L and Gingras, V and McLennan, N M and Most, J and Yamamoto, J M and Aiken, C E and Ozanne, S E and Reynolds, R M and Mohan, V (2023) Precision gestational diabetes treatment: a systematic review and meta-analyses. Communications Medicine, 3 (135).



Background: Gestational Diabetes Mellitus (GDM) affects approximately 1 in 7 pregnancies globally. It is associated with short- and long-term risks for both mother and baby. Therefore, optimizing treatment to effectively treat the condition has wide-ranging beneficial effects. However, despite the known heterogeneity in GDM, treatment guidelines and approaches are generally standardized. We hypothesized that a precision medicine approach could be a tool for risk-stratification of women to streamline successful GDM management. With the relatively short timeframe available to treat GDM, commencing effective therapy earlier, with more rapid normalization of hyperglycaemia, could have benefits for both mother and fetus. Methods: We conducted two systematic reviews, to identify precision markers that may predict effective lifestyle and pharmacological interventions. Results: There was a paucity of studies examining precision lifestyle-based interventions for GDM highlighting the pressing need for further research in this area. We found a number of precision markers identified from routine clinical measures that may enable earlier identification of those requiring escalation of pharmacological therapy (to metformin, sulphonylureas or insulin). This included previous history of GDM, Body Mass Index and blood glucose concentrations at diagnosis. Conclusions: Clinical measurements at diagnosis could potentially be used as precision markers in the treatment of GDM. Whether there are other sensitive markers that could be identified using more complex individual-level data, such as omics, and if these can feasibly be implemented in clinical practice remains unknown. These will be important to consider in future studies.

Item Type:Article
Official URL/DOI:
Uncontrolled Keywords:Gestational Diabetes
Subjects:Diabetology > Gestational Diabetes
Divisions:Department of Epidemiology
Department of Diabetology
ID Code:1408
Deposited By:surendar radha
Deposited On:24 Nov 2023 12:01
Last Modified:24 Nov 2023 12:01

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