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

Jamie L. Benham, Véronique Gingras, Niamh-Maire Mclennan, Jasper Most, Jennifer m. Yamamoto, Catherine Aiken, Susan e. Ozanne, Rebecca M. Reynolds, Deirdre k. Tobias, Jordi Merino, Abrar Ahmad, Catherine Aiken, Dhanasekaran Bodhini, Amy l. Clark, Kevin Colclough, Rosa Corcoy, Sara j. Cromer, Daisy Duan, Jamie l. Felton, Ellen c. FrancisPieter Gillard, Romy Gaillard, Eram Haider, Alice Hughes, Jennifer m. Ikle, Laura m. Jacobsen, Anna r. Kahkoska, Jarno l. t. Kettunen, Raymond j. Kreienkamp, Lee-Ling Lim, Jonna m. e. Männistö, Robert Massey, Niamh-Maire Mclennan, Rachel g. Miller, Mario luca Morieri, Rochelle n. Naylor, Bige Ozkan, Kashyap amratlal Patel, Scott j. Pilla, Katsiaryna Prystupa, Sridharan Raghavan, Mary r. Rooney, Martin Schön, Zhila Semnani-Azad, Magdalena Sevilla-Gonzalez, Pernille Svalastoga, Wubet worku Takele, Claudia ha-Ting Tam, Anne cathrine b. Thuesen, Mustafa Tosur, Amelia s. Wallace, Caroline c. Wang, Jessie j. Wong, Katherine Young, Chloé Amouyal, Mette k. Andersen, Maxine p. Bonham, Mingling Chen, Feifei Cheng, Tinashe Chikowore, Sian c. Chivers, Christoffer Clemmensen, Dana Dabelea, Adem y. Dawed, Aaron j. Deutsch, Laura t. Dickens, Linda a. Dimeglio, Monika Dudenhöffer-Pfeifer, Carmella Evans-Molina, María mercè Fernández-Balsells, Hugo Fitipaldi, Stephanie l. Fitzpatrick, Stephen e. Gitelman, Mark o. Goodarzi, Jessica a. Grieger, Marta Guasch-Ferré, Nahal Habibi, Torben Hansen, Chuiguo Huang, Arianna Harris-Kawano, Heba m. Ismail, Benjamin Hoag, Randi k. Johnson, Angus g. Jones, Robert w. Koivula, Aaron Leong, Gloria k. w. Leung, Ingrid m. Libman, Kai Liu, S. alice Long, William l. Lowe, Robert w. Morton, Ayesha a. Motala, Suna Onengut-Gumuscu, James s. Pankow, Maleesa Pathirana, Sofia Pazmino, Dianna Perez, John r. Petrie, Camille e. Powe, Alejandra Quinteros, Rashmi Jain, Debashree Ray, Mathias Ried-Larsen, Zeb Saeed, Vanessa Santhakumar, Sarah Kanbour, Sudipa Sarkar, Gabriela s. f. Monaco, Denise m. Scholtens, Elizabeth Selvin, Wayne huey-Herng Sheu, Cate Speake, Maggie a. Stanislawski, Nele Steenackers, Andrea k. Steck, Norbert Stefan, Julie Støy, Rachael Taylor, Sok cin Tye, Gebresilasea gendisha Ukke, Marzhan Urazbayeva, Bart Van der schueren, Camille Vatier, John m. Wentworth, Wesley Hannah, Sara l. White, Gechang Yu, Yingchai Zhang, Shao j. Zhou, Jacques Beltrand, Michel Polak, Ingvild Aukrust, Elisa De franco, Sarah e. Flanagan, Kristin a. Maloney, Andrew Mcgovern, Janne Molnes, Mariam Nakabuye, Pål rasmus Njølstad, Hugo Pomares-Millan, Michele Provenzano, Cécile Saint-Martin, Cuilin Zhang, Yeyi Zhu, Sungyoung Auh, Russell De souza, Andrea j. Fawcett, Chandra Gruber, Eskedar getie Mekonnen, Emily Mixter, Diana Sherifali, Robert h. Eckel, John j. Nolan, Louis h. Philipson, Rebecca j. Brown, Liana k. Billings, Kristen Boyle, Tina Costacou, John m. Dennis, Jose c. Florez, Anna l. Gloyn, Maria f. Gomez, Peter a. Gottlieb, Siri atma w. Greeley, Kurt Griffin, Andrew t. Hattersley, Irl b. Hirsch, Marie-France Hivert, Korey k. Hood, Jami l. Josefson, Soo heon Kwak, Lori m. Laffel, Siew s. Lim, Ruth j. f. Loos, Ronald c. w. Ma, Chantal Mathieu, Nestoras Mathioudakis, James b. Meigs, Shivani Misra, Viswanathan Mohan, Rinki Murphy, Richard Oram, Katharine r. Owen, Susan e. Ozanne, Ewan r. Pearson, Wei Perng, Toni i. Pollin, Rodica Pop-Busui, Richard e. Pratley, Leanne m. Redman, Maria j. Redondo, Rebecca m. Reynolds, Robert k. Semple, Jennifer l. Sherr, Emily k. Sims, Arianne Sweeting, Tiinamaija Tuomi, Miriam s. Udler, Kimberly k. Vesco, Tina Vilsbøll, Robert Wagner, Stephen s. Rich, Paul w. Franks

Research output: Contribution to journalArticlepeer-review

Abstract / Description of output

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 were 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.

Original languageEnglish
JournalCommunications Medicine
Volume3
Issue number1
DOIs
Publication statusPublished - 5 Oct 2023

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