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New test to identify obese women at high risk of developing diabetes in pregnancy

December 08, 2016

In 2014, around seven million women in the UK were classified as obese. By 2025, it is expected to affect 1 in 5 women in the world. Obesity is a major risk factor for gestational diabetes, increasing the likelihood of the disorder three - five fold. Women with the disorder require intensive antenatal care to control blood glucose and to identify other common complications, particularly fetal macrosomia - a newborn who's significantly larger than average.

In practice today, all obese pregnant women are categorised as being of equally high risk of gestational diabetes, whereas in reality, only around 25% will develop the disorder.

In the study, funded by the National Institute for Health Research (NIHR), the team looked at how to correctly identify obese women with heightened risk, early in pregnancy, and as a result, enable timely targeted intervention to those women most likely to benefit.

From the many factors tested, those that predicted gestational diabetes included older age, disease in a previous pregnancy, higher blood pressure and anthropometric measures such as skin thicknesses, waist and mid-arm circumferences. A number of blood tests, such as Haemoglobin A1c also added strength to the predictive tool.

Out of the 1303 women in the study, 337 were affected by gestational diabetes.

Lead author, Dr Sara White from King's College London said: "There is currently no accepted strategy to identify obese women at high risk of gestational diabetes, early in pregnancy. Today, all those classified as obese are considered high risk. With escalating rates of obesity worldwide, a more accurate way of defining risk is necessary in this group.

"In this, the largest and most comprehensive study to date, we have used an extensive range of different measures to develop prediction tools. One of our models focused on a few clinical factors and biomarkers already readily available in clinical practice and which incurred minimal cost. In addition, we have identified a model that does not require blood sampling, which could be developed for low and middle income countries where the prevalence of gestational diabetes and obesity is rapidly increasing.

"Clinical use of these tests would enable prompt intervention and correctly target those at highest risk and therefore most likely to benefit."

Dr White is continuing her research into gestational diabetes with the support of Diabetes UK.
-end-
Notes to editors:

1. About King's College London

King's College London is one of the top 25 universities in the world (2016/17 QS World University Rankings) and among the oldest in England. King's has more than 27,600 students (of whom nearly 10,500 are graduate students) from some 150 countries worldwide, and some 6,800 staff.

King's has an outstanding reputation for world-class teaching and cutting-edge research. In the 2014 Research Excellence Framework (REF) King's was ranked 6th nationally in the 'power' ranking, which takes into account both the quality and quantity of research activity, and 7th for quality according to Times Higher Education rankings. Eighty-four per cent of research at King's was deemed 'world-leading' or 'internationally excellent' (3* and 4*). The university is in the top seven UK universities for research earnings and has an overall annual income of more than £684 million.

For further information, please visit the website: http://www.kcl.ac.uk/newsevents/About-Kings.aspx

2. The National Institute for Health Research (NIHR) is funded by the Department of Health to improve the health and wealth of the nation through research. The NIHR is the research arm of the NHS. Since its establishment in April 2006, the NIHR has transformed research in the NHS. It has increased the volume of applied health research for the benefit of patients and the public, driven faster translation of basic science discoveries into tangible benefits for patients and the economy, and developed and supported the people who conduct and contribute to applied health research. The NIHR plays a key role in the Government's strategy for economic growth, attracting investment by the life-sciences industries through its world-class infrastructure for health research. Together, the NIHR people, programmes, centres of excellence and systems represent the most integrated health research system in the world. For further information, visit the NIHR website.

3. Dr White is continuing her research into gestational diabetes with the support of Diabetes UK.

King's College London

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