J Clin Endocrinol Metab. 2020 Dec 1;105(12):dgaa633. doi: 10.1210/clinem/dgaa633. PMID: 32898218.
In this study, low risk pregnant women had an early OGTT at 18-20 weeks of gestation and these results were correlated with the standard OGTT at 24-28 weeks. Pregnant women with Gestational diabetes mellitus (GDM) who had early OGTT still had a higher risk of delivering macrosomic infants with fetal hyperinsulinaemia.
GDM leads to maternal, neonatal and childhood complications. Mothers with GDM have a higher risk of developing type 2 diabetes later in life. In the newborn, GDM leads to macrosomia, polycythemia and hypoglycaemia. Infants of mothers with GDM have a higher risk of obesity and diabetes later in life. The diagnostic criteria for GDM and the optical timing of testing for GDM are debated. Most guidelines recommend undertaking an oral glucose tolerance test (OGTT) in low risk pregnancies between 24-28 weeks of gestation. The authors hypothesized that early diagnosis of GDM might help in early intervention and treatment to reduce the complications.
Their findings suggest that GDM diagnosed in low risk pregnant women, even as early as 18-20 weeks gestation, is still associated with adverse outcomes. Thus, early diagnosis and management of GDM in low risk pregnant women could help improve outcomes. As this was a prospective study, further randomized control trials comparing early and standard screening for GDM are required to understand if early intervention could have diagnostic and therapeutic benefits.