Gestational diabetes can increase the risk of type 2 diabetes in later life, as can high levels of fat in the liver. Dr Hanna is testing a screening programme, to see if women with gestational diabetes and high levels of fat in the liver are at a higher risk of type 2 diabetes overall. If so, this group of women could be supported to reduce their risk.
Background to research
Gestational diabetes is a type of diabetes that develops during pregnancy, and it can often disappear afterwards. However, many women that experience gestational diabetes go on to develop type 2 diabetes within 10 years. This means that detecting gestational diabetes is an important way to ensure a safe pregnancy and delivery, and could also be used to identify women at risk of type 2 diabetes.
Fat in the liver that isn’t related to excess alcohol consumption (known as non-alcoholic liver disease) is another risk factor of type 2 diabetes. This can be detected by ultrasound, or a scoring system that involves taking blood tests together with the person’s height, weight and waist circumference.
Dr Hanna believes that by checking for fat in the liver of women with gestational diabetes, they can identify those with the highest risk of developing type 2 diabetes. If successful, this could allow personal treatment plans to prevent or delay the onset of type 2 diabetes in these women.
The team plan to recruit pregnant women with gestational diabetes to the study and check for liver fat during a routine ultrasound scan. They would like to involve women with and without fat in their liver. After the pregnancy, they plan to study the levels of fat in the liver further, and carry out a glucose tolerance test. This will clarify whether the women with a fatty liver have more resistance to insulin than women without liver fat.
If the team can confirm that excess fat in the liver leads to more resistance to insulin, they will have identified a group of women with a very high risk of developing type 2 diabetes. This group can then be supported to reduce their risk, and take steps to prevent the onset of the condition.
Potential benefit to people with diabetes
This project is the first important step to developing a programme that detects the levels of fat in the liver in women with gestational diabetes as soon as possible. This will help these women to be supported to reduce their risk, and could be a strategy for preventing type 2 diabetes in the future.