The Fraternal Order of Eagles (FOE) Diabetes Research Center is pleased to announce the results of its sixth round of pilot and feasibility research grants. Three 2016-17 recipients were selected to receive $50,000 to support their research proposal, with the possibility of $100,000 over a two-year period.
The committee unanimously selected an additional proposal by Wei Bao, MD, PhD, CPH assistant professor of epidemiology, to receive $20,000 to support his research proposal, “Nontraditional glycemic markers in early pregnancy as predictors of gestational diabetes,” for one year.
Gestational diabetes mellitus (GDM) is a common pregnancy complication that affects ~9% of all pregnancies in the United States. GDM is usually diagnosed at 24-28 weeks of gestation by measuring fasting and post-load glucose in an oral glucose tolerance test (OGTT). Since GDM is associated with adverse health outcomes in the fetus and children, early prediction of GDM is imperative. However, the utility of glucose in early pregnancy for GDM prediction is limited because fasting glucose and OGTT are usually not available at that time. Using non-fasting blood glucose for GDM prediction is problematic due to the substantial glucose variability influenced by food intake. Nontraditional glycemic markers, including fructosamine, glycated albumin, and 1,5-anhydroglucitol (1,5-AG), do not require fasting; therefore they are perfect fit to the current clinical practice and can be measured in the same blood samples collected in early pregnancy for other routine lab tests.
We propose to conduct a nested case-control study in a prospective cohort of pregnant women. In this pilot study, we will measure nontraditional glycemic markers in first-trimester maternal plasma samples of pregnant women, and associate these markers with the risk of incident GDM. Moreover, we will assess the utility of these markers in the discrimination and prediction of GDM, as indicated by improved C-statistic and reclassification measures. Previous studies on the use of these markers for GDM prediction mainly used blood samples collected at the time of GDM diagnosis and the results have been conflicting. The proposed study is innovative because it represents a departure from the status quo by examining nontraditional glycemic markers in early pregnancy as early predictors for GDM. If successful, the proposed study may change the clinical paradigm in the screening and prediction of GDM. Findings from this study will be important to develop Specific Aims for subsequent NIH R01 projects that integrate multiple biochemical and genetic markers for improved GDM prediction in the era of “Precision Medicine.”