Gestational diabetes can be diagnosed in first trimester itself with help of gut microbes

Israel: A recent study published in the BMJ journal Gut has claimed that the onset of gestational diabetes mellitus (GDM) can be identified in the first trimester of pregnancy, earlier than typically detected.

The new study, led by Prof. Omry Koren of the Azrieli Faculty of Medicine of Bar-Ilan University and a team of Israeli and international researchers, is one of the first to show reliable prediction of GDM months before it is typically diagnosed.

There are marked differences in the first-trimester gut microbiota (the bacterial population found in the guts of humans and animals) of women who do and do not later develop gestational diabetes. These differences are associated with inflammatory markers, with women who develop gestational diabetes exhibiting higher inflammation and lower levels of beneficial metabolites.

Gestational diabetes mellitus (GDM) is when women without diabetes develop glucose intolerance during pregnancy. GDM, which plagues approximately 10% of pregnant women worldwide, is currently diagnosed in the second trimester of pregnancy.

In the study, faecal and serum samples were collected from pregnant women during their first trimester. The microbiota, metabolite, inflammation, and hormone profiles were characterized. Diet, smoking, and other lifestyle habits were recorded, and clinical/medical data was compiled from digital health records. Using the results of these characterizations and other collected data, Prof. Yoram Louzoun, from the Department of Mathematics and Gonda (Goldschmied) Multidisciplinary Brain Research Center, built a machine learning model that can accurately predict which women would and would not go on to develop gestational diabetes.

The researchers then demonstrated in animal models that transferring the first-trimester faeces of women who developed gestational diabetes results in the transfer of the diabetes phenotype to germ-free mice, suggesting that the gut microbiome has a role in mediating disease development. The study findings are not population specific. The microbiome model, for example, could predict GDM in Chinese women, and the mice results were replicated in Finnish and American cohorts.

"Recognition of women at risk of gestational diabetes at an early stage of pregnancy may allow specific recommendations for the prevention of the disease currently by lifestyle modification and in the future perhaps by specific pre, pro, and postbiotic supplementation," says Prof. Koren.

If gestational diabetes can be prevented, there would be a major reduction in adverse outcomes of gestational diabetes, for the mother and offspring, in both the short and long term, benefiting families worldwide.

Reference:

Pinto Y, Frishman S, Turjeman S, et al Gestational diabetes is driven by microbiota-induced inflammation months before diagnosisGut Published Online First: 10 January 2023. doi: 10.1136/gutjnl-2022-328406.