Western lead Australian-first studies into gestational diabetes

Gestational diabetes is the fastest growing type of diabetes in Australia. The disease can be associated with stillbirths and other severe harms and have long-term health impacts for both mothers and babies. Western Sydney University’s long-term commitment to addressing gestational diabetes has now intensified, with two new Australian-first research projects aimed at better understanding and managing the disease.

The first, published in the Medical Journal of Australia, is an investigation into the impact of treating gestational diabetes early in a pregnancy. Led by Professor David Simmons from the School of Medicine, the Treatment of Booking Gestational Diabetes Mellitus (TOBOGM) study, will investigate whether women diagnosed with hyperglycemia (high blood sugars) before 20 weeks’ gestation have better health outcomes than those diagnosed later in their pregnancy.

Identifying and managing women with gestational diabetes mellitus (GDM) from 24–28 weeks’ gestation is now standard care in Australia and overseas. However, many women – on the back of guideline from the World Health Organization and the International Association of Diabetes and Pregnancy Study Groups (IADPSG) – are now being screened for overt diabetes in pregnancy (ODIP) at their first antenatal appointment. Professor Simmons says the TOBOGM study, the first of its kind in Australia, will provide vital insights into the impact of such early intervention.

“Despite an increase in early testing for GDM in pregnant women, there is no conclusive evidence that diagnosing and treating GDM at a mothers’ first antenatal appointment (also known as booking GDM) is beneficial for mothers or their babies,” says Professor Simmons.

“In fact, some studies have delivered results which suggest there are negative effects of over-treating mothers too early which can lead to smaller babies and the possibility of future metabolic disease. Our TOBOGM study will provide data that will inform optimal diagnostic criteria and better health outcomes.

“Further, it will evaluate the cost-effectiveness of the screening, diagnosis and treatment of booking GDM. We expect that the results of the trial will guide future practice.”

A second study, also co-authored by Professor Simmons and published in Current Diabetes Report, delves into the connection between ethnicity and GDM. Ethnicity has long been described as a major risk factor for the development of GDM, and it is widely recognised that women from non-Caucasian ethnicities are at higher risk of developing the condition. What isn’t yet known is the reason for this.

Professor Simmons research, co-authored by PhD student Lili Yuen from Western Sydney University’s School of Medicine, concludes that various factors such as access to screening, body composition, genetics and gestational weight gain may result in ethnic disparities in the prevalence and outcomes of GDM.

“This research will help us better understanding GDM and in turn, better manage the condition,” says Professor Simmons.

These latest research projects come in addition to the Western Sydney University-led Diabetes Contraception and Pre-Pregnancy Program (DOMTRU) – a collaboration between Western Sydney University, South Western Sydney Local Health District and South-Western Sydney PHN – to ensure women with type one and type two diabetes are aware of the risks surrounding pregnancy, and provides them with multi-disciplinary support and care to help them minimise these risks.

This Australian-first program is aimed at reducing malformations in babies born to mothers with diabetes and has been rolled out across south western Sydney, with the start of a district-wide information program and opening of specialized clinics.

Professor Simmons, who is also Director of (DOMTRU) at Western Sydney University says the impact that pregnancy among women with pre-existing type 1 and type 2 diabetes is having on women, babies and the community demands the best resources and research efforts.

“I have seen first-hand the devastating effects that poorly prepared pre-existing diabetes can have during pregnancy on women and children. This condition demands the best of our research, resources and collaborative efforts – a combination which will no doubt result in better health outcomes,” says Professor Simmons.

This is an example of research making an impact – the focus of the 2018 Town & Gown Gala Dinner, supported by gold sponsors Brydens Lawyers, Charter Hall and PwC Australia.

ENDS

4 October 2018

Emma Sandham, Senior Media Officer