Gestational Diabetes Mellitus: A near-hidden danger

Genetic testing has revealed greater prospects in the early diagnosis of gestational diabetes mellitus.

Gestational Diabetes Mellitus (GDM) is currently the most frequent metabolic disorder during pregnancy. Alongside maternal obesity, it has become a growing health problem (1).

During pregnancy, the maternal hormonal production changes in order to enable the baby’s development.  For some women, such changes may result in gestational diabetes, which is a condition characterized by the glucose intolerance that develops or is first detected during pregnancy (2).

The GDM development is associated with a high risk of maternal-fetal complications. When the baby is exposed to large amounts of glucose still in the intrauterine environment, there is a greater risk of excessive fetal growth (fetal macrosomia) and, consequently, of traumatic births, neonatal hypoglycemia, in addition to obesity and diabetes in adulthood. Regarding the mother, studies show the association with a higher risk of pre-eclampsia and eclampsia, as well as damage to the kidneys and hypertension. Although GDM is likely to disappear after birth, approximately 40% to 60% of women may develop type 2 diabetes mellitus (2,3).

GDM can be developed by any woman, but some have risk factors that should be taken into consideration such as advanced maternal age, excessive weight gain during pregnancy, overweight or obesity, polycystic ovary syndrome, previous history of large babies (more than 4 kg) or gestational diabetes, family history of diabetes in first-degree relatives, family history of gestational diabetes in the mother of the pregnant woman, and systemic arterial hypertension during pregnancy (2). Currently, one in six births is estimated to be from women with some form of hyperglycemia during pregnancy, 84% of which would be consequences of the GDM (4).

The GDM symptoms are often imperceptible, although the risks are real. When diagnosed, some measures should be taken, such as maintaining a balanced diet and exercising, in order to keep glucose levels under control (2,3). Therefore, the early detection of the risk may be essential to reduce the high risk of complications.

The literature has shown that the presence of certain genetic variants associated with the development of Type 2 Diabetes Mellitus and other variants in genes related to obesity, folic acid deficiency and vitamin B12 deserve to be investigated as predictive factors of the development of GDM (5, 6). The presence of these genetic variants together with the patient’s gestational and family history have ensured important perspectives in the early diagnosis of GDM and assisted health professionals in decisions about prevention strategies and better control of the condition (1,2,4).

Following the latest discoveries in scientific studies and personalized medicine, SYNLAB developed the GDMpredictTM, the first genetic analysis to assess the predisposition to GDM in women who are still in the first weeks of pregnancy, being especially indicated for those women who have at least one of the risk factors. The test has also been indicated for women who are planning their pregnancy. A non-invasive test, GDMpredictTM enables the simultaneous analysis of 20 genetic variants that have already been associated with the risk of GDM in a single sample of maternal blood. The result is presented as a risk curve for the development of GDM during pregnancy based on a mathematical algorithm that integrates the different statistical weight of each variant, family history, and anthropometric data of the patient.

About SYNLAB

SYNLAB offers a full range of medical laboratory services for practising doctors, clinics and the pharmaceutical industry. The SYNLAB Group is the uncontested leader on the European market for human medicine laboratory services.

Bibliographical references

1. Bianchi C., et al. Pre-pregnancy obesity, gestational diabetes or gestational weight gain: which is the strongest predictor of pregnancy outcomes? Diabetes Res Clin Pract. 2018;144:286–

2. Sociedade Brasileira de Diabetes – https://www.diabetes.org.br/publico/diabetes-gestacional <Accessed on June 10, 2019>

3. Guillén-Sacoto, M. A., et al. Diabetes mellitus gestacional: control glucémico durante el embarazo y su relación con los resultados neonatales en embarazos gemelares y de feto único. Endocrinología, Diabetes y Nutrición, 2018.

4. RASTREAMENTO E DIAGNÓSTICO DE DIABETES MELLITUS GESTACIONAL NO BRASIL. https://www.diabetes.org.br/profissionais/images/pdf/diabetes-gestacional-relatorio.pdf. <Accessed on June 10, 2019>

5. K. Kawai et al., A genetic risk score that includes common type 2 diabetes risk variants is associated with gestational diabetes. Clinical Endocrionology (2017).

6. Beysel, S., et al. Maternal genetic contribution to pre-pregnancy obesity, gestational weight gain, and gestational diabetes mellitus. Diabetology & Metabolic Syndrome (2019)