Potential new screening test for gestational diabetes

Researchers at the Brigham and Women's Hospital have been investigating a protein called CD59 for several years. As part of that research they developed an immunoassay that can measure levels of glycated CD59 (GCD59) in blood.

Glycated proteins are proteins that have a sugar molecule attached such as glycated haemoglobin and glycated albumin. Higher levels of glycated proteins are found in people with high blood sugar levels and diabetes.

In a recent study published in the journal Diabetes Care they have now shown that this novel biomarker for diabetes may have potential for replacing the oral glucose tolerance test for screening pregnant women for gestational diabetes. The researchers conducted a case-control study of 1,000 pregnant women who were receiving standard prenatal care at the hospital. Five hundred women who had a normal glucose challenge test and 500 women who failed the glucose challenge test and required a subsequent oral glucose tolerance test (GTT). They found that women who failed either the screening glucose challenge test or both the glucose challenge test and the follow-up full glucose tolerance test had much higher levels of GCD59 in their blood than the women with normal tests.

In this study the researchers found that at weeks 24-28 of gestation the test was able to identify both women who failed the glucose challenge test and women with gestational diabetes. Plasma levels of GCD59 were also associated with the probability of delivering a large-for-gestational-age baby.

If these findings are verified in larger studies in the general population then there is potential for this much simpler test to replace the standard glucose tolerance test that is currently used to screen pregnant women in Australia. The standard GTT requires the women to have a regular diet prior to the test, to fast on the day of the test and to wait two hours after drinking the glucose drink for the final blood sample.

It will be some time before we know whether this test will be a feasible replacement for the GTT as more studies are required to see if this test will work as a stand-alone test or perhaps as a screen to eliminate the need for a GTT in the bulk of women with a low risk as determined by the GCD59 test.

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