ArticlePloS one2020
Metabolic phenotyping by treatment modality in obese women with gestational diabetes suggests diverse pathophysiology: An exploratory study.
Article in PloS one, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed.
- Altered Lipid Metabolism in Obese Women With Gestational Diabetes and Associations With Offspring Adiposity.The Journal of clinical endocrinology and metabolism · 2022Trial
- GDM as a unique pathophysiological entity or a transitional pregnancy-induced glucose metabolism abnormality identifying primary diabetes types?Frontiers in physiology · 2026Review
- Precision Prevention, Diagnostics, and Treatment of Obesity: Pipedream or Reality?Obesity (Silver Spring, Md.) · 2025Review
- Biomarkers predicting adverse pregnancy outcomes in women living with obesity: a systematic review and meta-analysis.AJOG global reports · 2025Review
- Review
- Maternal Serum Metabolomics in Mid-Pregnancy Identifies Lipid Pathways as a Key Link to Offspring Obesity in Early Childhood.International journal of molecular sciences · 2024Article
- Association of Maternal Metabolites and Metabolite Networks with Newborn Outcomes in a Multi-Ancestry Cohort.Metabolites · 2023Article
- Metabolic Profiling of Pregnant Women with Obesity: An Exploratory Study in Women at Greater Risk of Gestational Diabetes.Metabolites · 2022Article
- Current progress in metabolomics of gestational diabetes mellitus.World journal of diabetes · 2021Review
- Gestational Diabetes Mellitus (GDM) Risk for Declared Family History of Diabetes, in Combination with BMI Categories.International journal of environmental research and public health · 2021Article
- Development of a New Risk Score for Stratification of Women with Gestational Diabetes Mellitus at High Risk of Persisting Postpartum Glucose Intolerance Using Routinely Assessed Parameters.Life (Basel, Switzerland) · 2021Article
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Authors and funding
11 authors.
Funding
Abstract
background and purposeExcess insulin resistance is considered the predominant pathophysiological mechanism in obese women who develop gestational diabetes (GDM). We hypothesised that obese women requiring differing treatment modalities for GDM may have diverse underlying metabolic pathways.
methodsIn this secondary analysis of the UK pregnancies Better Eating and Activity Trial (UPBEAT) we studied women from the control arm with complete biochemical data at three gestational time points; at 15-18+6 and 27-28+6 weeks (before treatment), and 34-36+0 weeks (after treatment). A total of 89 analytes were measured (plasma/serum) using a targeted nuclear magnetic resonance (NMR) platform and conventional assays. We used linear regression with appropriate adjustment to model metabolite concentration, stratified by treatment group. MAIN
findings300 women (median BMI 35kg/m2; inter quartile range 32.8-38.2) were studied. 71 developed GDM; 28 received dietary treatment only, 20 metformin, and 23 received insulin. Prior to the initiation of treatment, multiple metabolites differed (p<0.05) between the diet and insulin-treated groups, especially very large density lipoprotein (VLDL) and high density lipoprotein (HDL) subclasses and constituents, with some differences maintained at 34-36 weeks' gestation despite treatment. Gestational lipid profiles of the diet treatment group were indicative of a lower insulin resistance profile, when compared to both insulin-treated women and those without GDM. At 28 weeks' the diet treatment group had lower plasma fasting glucose and insulin than women treated with insulin, yet similar to those without GDM, consistent with a glycaemic mechanism independent of insulin resistance. CONCLUSIONS/
interpretationThis exploratory study suggests that GDM pathophysiological processes may differ amongst obese women who require different treatment modalities to achieve glucose control and can be revealed using metabolic profiling.
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