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17 October 2019

Researchers discover potential marker for developing gestational diabetes

Research from King’s have found a molecule that controls insulin production during pregnancy is lower in women with gestational diabetes which could lead to identifying women who are at-risk of developing the condition.

diabetes

By blocking the effects of the molecule, kisspeptin, in pregnant mice, a team of researchers led by Dr James Bowe from the Department of Diabetes, found that mice demonstrated symptoms like those seen in gestational diabetes, such as high blood glucose. These findings published today in JCI Insight, suggest that placental kisspeptin is essential for the regulation of blood glucose during pregnancy.

The team also found that the circulating levels of kisspeptin are lower in pregnant women with gestational diabetes suggesting that reduced placental kisspeptin production may be a factor in the development of gestational diabetes in humans.

Kisspeptin (a short peptide molecule) is made by the placenta during pregnancy and released into the mother’s circulation. One of its roles is to influence the insulin-secreting beta cells in the pancreas to secrete more insulin to enable the mother to cope with the metabolic demands of pregnancy.

Gestational diabetes currently affects approximately 5% of human pregnancies and is associated with increased risk of complications for both the mother and the baby such as macrosomia (excess growth) and poor glucose control in the baby as well as increased risk of birth complications in the mother. It is also associated with increased risk of subsequent development of type 2 diabetes in both the mother and baby.

At present, gestational diabetes is currently diagnosed through an oral glucose tolerance test once the condition has developed. Where possible gestational diabetes is then treated through lifestyle interventions, however medications such as metformin, glibenclamide and insulin are also used if necessary.

These findings suggest that using measurements of circulating kisspeptin as an early risk marker for the development of gestational diabetes in pregnant women to allow early interventions in an “at-risk” group.

This research has found that kisspeptin is involved in helping the mother cope with the metabolic demands of pregnancy. Thus, kisspeptin may have clinical potential for diagnosing, preventing or treating gestational diabetes.

Dr James Bowe

The next steps in this research are to investigate the regulation of kisspeptin released by the placenta and determine why it fails in gestational diabetes and to initiate clinical trials of kisspeptin to improve the regulation of blood glucose in pregnant women at risk of developing gestational diabetes. 

Read the paper here.