This project took place at our London centre which operated between 1995 and 2021.
Why do we need this research?
When women are obese, they are at greater risk of developing diabetes in pregnancy – known as gestational diabetes – and this can increase the chances of them experiencing pregnancy complications, such as the baby growing too fast or being stillborn. Women with gestational diabetes are also at risk of developing type 2 diabetes in the future, and their children are more likely to be obese or diabetic. Right now, all obese women are considered to be at high risk, even though more than 70% of them will be free from diabetes during pregnancy.
Gestational diabetes is currently diagnosed between 24 and 28 weeks of pregnancy using an oral glucose tolerance test (OGTT). However, this test has two major drawbacks. Firstly, the OGTT is time-consuming, meaning some women aren’t able to attend the appointment. Secondly, we now know that the test is taken too late in pregnancy, because the metabolism of women with gestational diabetes changes before the 24–28-week mark and so babies may have already started to grow too much.
We want to find a way of identifying women who are at high risk of gestational diabetes earlier in their pregnancies so that they can get the treatment and support they need.
What’s happening in this project?
Using data from the UPBEAT trial of more than 1,500 women, researchers funded by Tommy’s previously developed a simple tool that can be used to work out which obese pregnant women are most likely to benefit from early attempts to reduce their chances of developing gestational diabetes – such as making diet changes or taking tablets. The tool uses the results of a blood test, as well as clinical information and body measurements collected at a single antenatal appointment (such as age and waist circumference), to work out whether a woman is high risk or not.
The team are now testing how well the tool works among a multi-ethnic group of obese pregnant women in London. So far, 220 women have agreed to take part in the study.
What difference will this project make?
In this project, we will find out whether the new tool can be used to predict early in pregnancy which obese women are most likely to develop gestational diabetes and would benefit from treatment that could prevent this from happening. If this tool is effective, it has the potential to reduce the risk of complications for women and their babies. It will also mean that women who are found to be at lower risk of diabetes don’t receive unnecessary treatment.
