Can Gestational Diabetes Be Detected Earlier? - Chromatography Finds Out

Gestational diabetes happens when you get high blood glucose levels (hyperglycaemia) when you are pregnant. It usually happens relatively late in the pregnancy during the trimester between 24 and 28 weeks. For most women, gestational diabetes disappears after the baby is born. In the UK it occurs in around 4% of pregnancies, in the US around 10% of pregnancies.

Gestational diabetes can potentially cause short- and long-term complications for both mother and child. It would be useful therefore to know how likely a pregnant woman is to get gestational diabetes. A paper published in the journal Current Developments in Nutrition reports on a study carried out by researchers in the US to identify metabolites that differed in the first and third trimesters of gestational diabetes and non-gestational diabetes pregnancies.

Hormonal changes and insulin

During pregnancy, a woman experiences many hormonal changes as her body adapts to pregnancy. One of the hormonal changes is to do with the hormone insulin. The placenta produces hormones that resist insulin during the second and third trimesters. These hormone changes along with the growing baby place increasing demands on the woman. And her insulin needs can double or even triple their normal state.

The insulin is needed to take the glucose from the blood supply into the cells for energy. If the body does not produce enough insulin, then you can get a high glucose or sugar level in the blood stream leading to high blood sugars. And the pregnant woman can then develop gestational diabetes. In most cases this can be managed by diet changes and exercise, or in a very few cases insulin will be needed to control the blood sugar levels. Knowing if a woman is at a higher risk could help reduce the risks associated with gestational diabetes.

Chromatography analyses the plasma

In the study referenced above, the researchers analysed the plasma metabolites in 68 from one of the main categories of pregnant women who might suffer from gestational diabetes – overweight and obese women. The researchers analysed blood plasma samples from the study group and a control group taken in the first (10-16 weeks) and third (28-35) weeks trimesters.

The samples were analysed by ultra-high-performance liquid chromatography-hybrid triple‐quadrupole linear ion trap mass spectrometry (UPLC-QTRAP). The use of a triple quadrupole mass spectrometer in chromatography is discussed in the article, Measurement of Pesticides in Cannabis sativa and Hemp Matrices Using a Gas Chromatograph-Triple Quadrupole Mass Spectrometer.

The team identified 243 metabolites in the plasma samples. In the first trimester samples they found complex lipids like cholestryl esters and phospholipids were higher in the group who get gestational diabetes. In the third trimester samples they found that acylcarnitine compounds were lower in the gestational diabetes group.  They conclude metabolite differences between GDM (diabetes) and Non-GDM (non-diabetes) groups in plasma samples collected during first trimester may predict the development of GDM (diabetes).