New screening test offers early diabetes prediction for pregnant women

Gestational diabetes mellitus, affecting 10 per cent to 17 per cent of pregnant women globally, is one of the most prevalent conditions during pregnancy.

Despite numerous attempts, previous efforts to develop a reliable screening method for early detection have fallen short. One of the main challenges has been accurately identifying higher-risk markers, which have either proven difficult to gauge or lacked sufficient prediction accuracy.

Researchers from Semmelweis University and the University of Debrecen in Hungary have unveiled a revolutionary method that allows for the early prediction of later-onset gestational diabetes mellitus (GDM) like never before.

The study has been published in the Journal of Clinical Endocrinology and Metabolism.

This screening test, the first of its kind in the world, not only finds a way to prevent diabetes from happening but also opens new avenues for timely intervention.

Typically, screening for GDM is recommended at the 24-week mark or later. However, with the introduction of early screening, prevention can be done before that.

The researchers examined biological samples and follow-up data from 2,545 pregnant women, sourced from Debrecen University’s biobank.

By analysing various parameters such as oxidative-nitrative stress-related markers, steroid hormone levels, and metabolites, they were able to find out the complexities of pregnancy pathologies.

Eszter M. Horvath, associate professor at the Department of Physiology at Semmelweis University and the corresponding author of the study, explained, “The placenta acts as a ‘steroid factory,’ with the quantity and composition of steroids produced varying in different pregnancy pathologies. Alterations in the tested steroid levels can indicate underlying changes occurring within the pregnancy.”

The team identified five markers that demonstrated the potential for detecting subtle deviations during the early stages of pregnancy.

These markers include fructosamine, which reflects average blood glucose levels over the preceding 2 to 3 weeks, soluble urokinase plasminogen activator receptor (suPAR), a marker highly correlated with other inflammation markers and often elevated in type 1 and type 2 diabetes patients, and three steroid hormones: cortisol, cortisone, and 11-deoxycorticosterone.

With the incorporation of these groundbreaking predictors alongside well-established risk factors like age and weight, the researchers devised a method that boasts an unprecedented accuracy rate of nearly 100 per cent in predicting later-onset GDM (between the 24th and 28th weeks of pregnancy) during the first trimester.