A new study led by 'Brigham and Women's Hospital' researchers, in Boston, United States, has found that a single measurement of glycosylated plasma CD59 (GCD59), a new biomarker for diabetes, in the 24-28 gestation weeks identified, with high sensitivity and specificity, to women who failed in the glucose challenge test, as well as women with gestational diabetes.The plasma levels of GCD59 were also linked to the probability of having a large baby for gestational age, as detailed in ‘Care Diabetes’.
Gestational diabetes is a type of diabetes that occurs during a woman's pregnancy, increasing the mother's risk of having a large baby for gestational age, which can lead to premature birth, fetal lesions, perinatal mortality and caesarean section.Gestational diabetes is also a risk factor for preeclampsia and gestational hypertension.
Since the treatment of gestational diabetes may reduce the risk of adverse pregnancy results, practice guides recommend reviewing all non -diabetic pregnant women for the disease.The current care standard for both screening and for the diagnosis of gestational diabetes predominantly implies a two -step approach.
The first step, known as glucose stimulation test, includes the administration of a sugary drink followed by a blood sugar measurement an hour later.Women who do not exceed this test are sent to a longer test, called oral glucose tolerance test, which requires fasting during the night, drinking a more concentrated sugar solution and undergoing basal blood drainage and time for three hours.
These glucose tests, or their variations, are currently the only methods used to examine pregnant women or to diagnose gestational diabetes.However, it is tests that consume a lot of time, they are cumbersome and uncomfortable for mothers and have bad reproducibility.The main objective of the research equipment was to evaluate the accuracy of the GCD59 diabetes biomarker in the prediction of the standard attention challenge tests used to detect gestational diabetes.The team conducted a case-control study of a thousand pregnant women who received standard prenatal care in the BWH: 500 women who had a normal glucose challenge test (control subjects) and 500 women who failed in the glucose test and required aOral tolerance tests after glucose (patients).
Gestational diabetes is a type of diabetes that occurs during a woman's pregnancy, increasing the mother's risk of having a large baby for gestational age, which can lead to premature birth, fetal lesions, perinatal mortality and caesarean section
The researchers discovered that, compared to the control subjects, the average plasma value of GCD59 was 8.5 times higher in patients who had not passed the stimulation test with glucose and ten times greater in the subgroup of these patients who met theDiagnostic criteria of gestational diabetes in the oral glucose tolerance test."This is the first study that demonstrates that a single measurement of GCD59 plasma can be used as a simplified method to identify women who are at risk of not passing the glucose challenge test and are at a greater risk of developing gestational diabetes," he saysThe doctor and researcher Jose Halperin, director of the Hematology Laboratory for Translational Research at BWH and main author of the publication.
Scientists also found that the highest plasma levels of GCD59 in theGestation week 24-28 were associated with a higher prevalence of large newborns for gestational age, the higher the level, the greater the risk (4 percent more risk for patients in the lowest quartile ofThe plasma levels of GCD59 and 14 percent in the highest quartile).
Of the 58 large babies for gestational age born to mothers who did not exceed glucose challenge test in this study, 80 percent were born of mothers who did not comply with the criteria for tolerance to oral glucose for gestational diabetes, but they had middle plasma levels of GCD59 seven times higher than control women with a normal glucose challenge test.
These findings are consistent with other studies that show that women who do not exceed the glucose challenge test, but do not meet the criteria for gestational diabetes, are still at a greater risk of abnormal results of pregnancy, including large babies' lightingFor gestational age.At present there are no practice guides for the management of women who are between normal and abnormal levels of glucose tolerance and, therefore, their management is the same as for women with normal results of the glucose test.
"These results suggest that a single GCD59 plasma measurement during the 24-28 weeks can also help stratify the risk of lighting larger babies among women with gestational glucose intolerance," says Halperin.Our studies opened a route for broader multicentric studies to further evaluate the clinical utility of GCD59 plasma for the detection and diagnosis of gestational diabetes among the general population of the United States.If our results are confirmed, we hope that the GCD59 test could be available in clinical practices within the coming years.
