Gut Microbes to Help Diagnose Gestational Diabetes in First Trimester

A new Bar-Ilan University study has found that gestational diabetes can be diagnosed as early as the first trimester of pregnancy -- months earlier than typically detected. 

Gestational Diabetes Mellitus (GDM) is a condition in which 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. 

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.  

Fecal and serum samples were collected from pregnant women during their first trimester and the characterized microbiota, metabolite, inflammation, and hormone profiles were characterized. In addition, 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 develop gestational diabetes.

Using animal models, the researchers then demonstrated that transferring the first trimester feces 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 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 perhaps by specific pre, pro, and postbiotic supplementation," says Prof. Koren.

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

The study was published in the journal Gut.