Original Article
Question: What is the impact of early pregnancy microbiome on gestational diabetes mellitus (GDM) development?
Design/Method: Across three distinct cohort studies, the gut microbiome, metabolome, inflammatory cytokines, diet, and clinical records of 394 pregnant women were examined. Biomarker analysis, including fasting glucose, liver enzymes, and HbA1c, serum cytokine and hormone panels, and bacterial DNA extraction from all faecal samples were used and a model was developed to forecasting the development of Gestational diabetes mellitus (GDM) weeks ahead of the usual diagnosis
Setting: Israel
Patients/ Study community: Pregnant women in the first trimester of pregnancy
Results: It is possible to detect GDM earlier than currently acknowledged—in the first trimester of pregnancy. Additionally, there is evidence that the gut microbiome contributes to the inflammation-induced pathogenesis of GDM, with interleukin-6 possibly playing a role in this process. Potential markers of GDM, such as microbiota, can be used as targets for early diagnostics and preventative therapeutic intervention
Commentary: Early pregnancy identification of women at risk of gestational diabetes mellitus (GDM) combined with adequate risk stratification may enable targeted recommendations for disease prevention, currently through lifestyle modification and maybe in the future with pre/pro/postbiotic supplementation. The long- and short-term negative effects of GDM for the mother and children would significantly decrease if the disease could be prevented
Citation: Pinto Y, Frishman S, Turjeman S, Eshel A. Gestational diabetes is driven by microbiota-induced inflammation months before. Gut 2023; 72:918–928
DOI: 10.1136/gutjnl-2022-328406
https://gut.bmj.com/content/72/5/918.long
Topics: Gestational Diabetes, Microbiota, Inflammation
