Lancet Journal Symposium—Time for a Paradigm Shift? Should We Treat Early Gestational Diabetes Mellitus?
Monday, June 24, at 1:30 p.m. ET
Room W304 E-H
Orange County Convention Center
Further Considerations for the Early Diagnosis of Gestational Diabetes Mellitus
Patrick Catalano, MD
Professor of Obstetrics and Gynecology,
Tufts Medical Center
What is your presentation about?
There has been a movement to diagnose gestational diabetes (GDM) in early pregnancy to improve perinatal outcomes. The results so far have proved mixed. My discussion will focus on the physiology of early pregnancy that makes interpretation of oral glucose tolerance in early pregnancy difficult to diagnose GDM.
How do you hope your presentation will impact diabetes research or care?
I think that it is important to know the limitations of our current testing methods. Because other methodologies for e.g. CGM may prove better and less of a patient burden. By providing physiologic data that is the basis of our current diagnosis and treatment methods, future research will better be able to move forward in the future avoiding mistakes of the past.
How did you become involved with this area of diabetes research or care?
I had great interdisciplinary mentors in obstetrics (Jim Clapp and Leon Mann) and endocrinology (Ethan Sims). I have also been fortunate to work with a multidisciplinary team of clinicians, and basic science researchers. Last, I have been fortunate to have NIH funding to continue my research.
How Should We Diagnose Early Gestational Diabetes Mellitus?
Arianne Sweeting, MBBS Hons, BSc, GradDip HL, FRACP, PhD
Endocrinologist,
Royal Prince Alfred Hospital
What is your presentation about?
The diabetes and obesity epidemics, as well as recent evidence for gestational diabetes heterogeneity by timing and subtype, provides an epidemiological and clinical rationale for detection and treatment of early gestational diabetes (diagnosed prior to 20 weeks gestation). This presentation summarizes the current international recommendations for early testing, examines the recent evidence for various glycemia-based testing approaches, and proposes diagnostic glycemic thresholds for early gestational diabetes.
How do you hope your presentation will impact diabetes research or care?
I hope this presentation demonstrates that we should be moving towards a paradigm of earlier identification and treatment of gestational diabetes globally, and how that approach might look clinically. Recognizing heterogeneity in gestational diabetes is an important step towards developing and implementing evidence-based precision medicine prevention, diagnostic and treatment strategies to improve the well-being of those with both early and late gestational diabetes and their offspring across the life course.
How did you become involved with this area of diabetes research or care?
Improving maternal health outcomes, particularly relating to diabetes in pregnancy, has always been a major driving force, and ultimately led me to leave law for medicine. Diabetes in pregnancy continues to have (and rightly so!) an outsized impact—rich in history and pioneers in diabetes research—with high-quality collaborative research that continues to evolve the field and seeks to fundamentally improve intergenerational health and well-being.