Visual Abstract

About 1/3 of GDM patients end up with insulin therapy due to failure of glucose control after diet modification. Interestingly, their glucose and HbA1c levels at the time of diagnosis may not be higher than those of GDM women who do not need insulin therapy. Therefore, identifying an indicator of insulin therapy in GDM is useful. Thirty-three women diagnosed with GDM by 100-g OGTT were enrolled. Blood and feces were collected at the time of GDM diagnosis (1st-2nd trimester; pre-treatment) and before delivery (GA ≥37 weeks; post-treatment). During the follow-up, 8 of 33 ended up with insulin therapy, while 25 of 33 could control their glucose levels by diet modification. BMI, fasting glucose, 2-h glucose, and HbA1c levels showed no difference between groups at pre-treatment. However, gut microbiota analysis in feces revealed that Eubacteria, Clostridiales, Lactobacillus, Bacteroidetes, and Enterobacteria were higher in insulin therapy group at pre-treatment (Figure 1). At post-treatment, all blood parameters and gut microbiota did not differ between groups (Figure 1). The results suggest that insulin therapy could attenuate gut dysbiosis. Interestingly, gut dysbiosis could be an indicator for insulin treatment in GDM. Thus, early modification of gut microbiota to relieve gut dysbiosis prior to the development of GDM may prevent insulin therapy as well as control glucose level throughout pregnancy.


L. Huang: None. C. Thonusin: None. P. Sililas: None. S. Luewan: None. T. Tongsong: None. N. Chattipakorn: None. S. C. Chattipakorn: None.


National Research Council of Thailand (to S.C.C.); Thailand Science Research and Innovation (MRG6280014); National Science and Technology Development Agency Thailand (to N.C.)

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