Grant: Operating Grant

Women with gestational diabetes (GDM) are at higher risk of having large babies, delivery problems & type 2 DM in the 4th-7th decades of life. The central cause may be deep abdominal fat and perhaps liver fat, reflective of a process called "insulin resistance" (IR). Current screening for GDM at 24-28 weeks of pregnancy uses a blood sugar test, which may be too little, too late, since IR may contribute to large baby growth starting in early pregnancy. We need a better method to identify women at risk of developing GDM who may have IR in early pregnancy. In a pilot study, we showed that ultrasound assessment of maternal deep abdominal fat at 12 weeks of pregnancy predicted sugar problems in later pregnancy. We will expand & improve on that study among a multicultutral cohort of 500 pregnant women. We will measure deep abdominal fat using ultrasound at 12 weeks of pregnancy, & assess how each predicts both blood sugar levels at 24-28 weeks & mother & baby health outcomes. In a sub-study, 1 in 4 of the 500 participants will have another ultrasound of their deep abdominal fat 6 weeks after delivery, alongside blood & insulin levels, to see how they each change from early pregnancy. GDM affetcs 3-10% of all pregnancies, and is a common health concern. Our research will generate an early GDM screening tool easily integretated into clinical practise, to enable earlier dietary therapy than is possible now. This should improve pregnancy outcomes, and may also help idendify women with GDM who are at highest risk of type 2 DM following their pregnancy.