ArticleThe Journal of clinical endocrinology and metabolism2023
Towards Precision Medicine in Gestational Diabetes: Pathophysiology and Glycemic Patterns in Pregnant Women With Obesity.
Article in The Journal of clinical endocrinology and metabolism, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed, 14 citations in OpenAlex.
- Lipidomic signatures in gestational diabetes mellitus and postpartum type 2 diabetes mellitus: a narrative review of etiologic and predictive implications.EBioMedicine · 2026Review
- Precision Medicine and Shared Decision-Making to Advance Gestational Diabetes Management: Genetic, Metabolic, and Gut Microbiota Factors.Patient preference and adherence · 2026Review
- Gestational diabetes mellitus subtypes: from one-size-fits-all to precision medicine.Hormones (Athens, Greece) · 2025Review
- Lipidomic signatures in maternal blood and placenta: Systematic evidence linking lipid profiles to pregnancy outcomes and fetal growth.Metabolism open · 2025Review
- Gestational diabetes mellitus subtypes according to oral glucose tolerance test and pregnancy outcomes.Endocrine · 2025Article
- Biomarkers predicting adverse pregnancy outcomes in women living with obesity: a systematic review and meta-analysis.AJOG global reports · 2025Review
- Remnant cholesterol in early pregnancy as a predictor of gestational diabetes mellitus beyond triglyceride levels: a retrospective cohort study.BMC pregnancy and childbirth · 2025Article
- Association of overweight/obesity and insulin resistance with activation of circulating innate lymphoid cells in women after gestational diabetes mellitus.Frontiers in immunology · 2025Observational
- Position statement of Italian Society of Obesity (SIO): Gestational Obesity.Eating and weight disorders : EWD · 2024Review
- Clinical Risk Factors and First Gestational 75 g OGTT May Predict Recurrent and New-Onset Gestational Diabetes in Multiparous Women.Journal of clinical medicine · 2024Article
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Authors and funding
6 authors at 2 institutions in 1 country.
Funding
Abstract
aimsPrecision medicine has revolutionized our understanding of type 1 diabetes and neonatal diabetes but has yet to improve insight into gestational diabetes mellitus (GDM), the most common obstetric complication and strongly linked to obesity. Here we explored if patterns of glycaemia (fasting, 1 hour, 2 hours) during the antenatal oral glucose tolerance test (OGTT), reflect distinct pathophysiological subtypes of GDM as defined by insulin secretion/sensitivity or lipid profiles.
methods867 pregnant women with obesity (body mass index ≥ 30 kg/m2) from the UPBEAT trial (ISRCTN 89971375) were assessed for GDM at 28 weeks' gestation (75 g oral glucose tolerance test OGTT; World Health Organization criteria). Lipid profiling of the fasting plasma OGTT sample was undertaken using direct infusion mass spectrometry and analyzed by logistic/linear regression, with and without adjustment for confounders. Insulin secretion and sensitivity were characterized by homeostatic model assessment 2b and 2s, respectively.
resultsIn women who developed GDM (n = 241), patterns of glycaemia were associated with distinct clinical and biochemical characteristics and changes to lipid abundance in the circulation. Severity of glucose derangement, rather than pattern of postload glycaemia, was most strongly related to insulin action and lipid abundance/profile. Unexpectedly, women with isolated postload hyperglycemia had comparable insulin secretion and sensitivity to euglycemic women, potentially indicative of a novel mechanistic pathway.
conclusionsPatterns of glycemia during the OGTT may contribute to a precision approach to GDM as assessed by differences in insulin resistance/secretion. Further research is indicated to determine if isolated postload hyperglycemia reflects a different mechanistic pathway for targeted management.
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