{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T23:14:53Z","timestamp":1782429293144,"version":"3.54.5"},"reference-count":33,"publisher":"The Endocrine Society","issue":"10","license":[{"start":{"date-parts":[[2023,3,23]],"date-time":"2023-03-23T00:00:00Z","timestamp":1679529600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000268","name":"Biotechnology and Biological Sciences Research Council","doi-asserted-by":"publisher","award":["BB\/M027252\/1"],"award-info":[{"award-number":["BB\/M027252\/1"]}],"id":[{"id":"10.13039\/501100000268","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000361","name":"Diabetes UK","doi-asserted-by":"publisher","award":["14\/0004849"],"award-info":[{"award-number":["14\/0004849"]}],"id":[{"id":"10.13039\/501100000361","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000361","name":"Diabetes UK","doi-asserted-by":"publisher","award":["17\/0005712"],"award-info":[{"award-number":["17\/0005712"]}],"id":[{"id":"10.13039\/501100000361","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Tommy's Charity"},{"DOI":"10.13039\/501100001648","name":"European Foundation for the Study of Diabetes\u2014Novo Nordisk Foundation","doi-asserted-by":"publisher","award":["NNF19SA058974"],"award-info":[{"award-number":["NNF19SA058974"]}],"id":[{"id":"10.13039\/501100001648","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001648","name":"European Foundation for the Study of Diabetes\u2014Novo Nordisk Foundation","doi-asserted-by":"publisher","award":["MC-UU-12012\/4"],"award-info":[{"award-number":["MC-UU-12012\/4"]}],"id":[{"id":"10.13039\/501100001648","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000272","name":"National Institute of Health Research","doi-asserted-by":"publisher","award":["RP-PG-0407-10452"],"award-info":[{"award-number":["RP-PG-0407-10452"]}],"id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000265","name":"Medical Research Council UK","doi-asserted-by":"crossref","award":["MR\/L002477\/1"],"award-info":[{"award-number":["MR\/L002477\/1"]}],"id":[{"id":"10.13039\/501100000265","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100014589","name":"Chief Scientist Office, Scottish Government Health Directorates","doi-asserted-by":"publisher","award":["CZB\/A\/680"],"award-info":[{"award-number":["CZB\/A\/680"]}],"id":[{"id":"10.13039\/100014589","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100014461","name":"Biomedical Research Centre","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100014461","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004941","name":"Guys & St Thomas NHS Foundation Trust","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004941","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000764","name":"King's College London","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000764","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100015250","name":"National Institute for Health Research Bristol Biomedical Research Centre","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100015250","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000306","name":"Tommy's Charity, UK","doi-asserted-by":"publisher","award":["SC039280"],"award-info":[{"award-number":["SC039280"]}],"id":[{"id":"10.13039\/501100000306","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100018956","name":"Cambridge Biomedical Research Centre","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100018956","id-type":"DOI","asserted-by":"publisher"}]},{"name":"core biochemical assay laboratory"},{"name":"core metabolomic and lipidomic laboratory"},{"DOI":"10.13039\/501100000276","name":"Department of Health and Social Care","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000276","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,9,18]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Aims<\/jats:title>\n                  <jats:p>Precision medicine has revolutionized our understanding of type 1 diabetes and neonatal diabetes but has yet to improve insight into gestational diabetes mellitus (GDM), the most common obstetric complication and strongly linked to obesity. Here we explored if patterns of glycaemia (fasting, 1 hour, 2 hours) during the antenatal oral glucose tolerance test (OGTT), reflect distinct pathophysiological subtypes of GDM as defined by insulin secretion\/sensitivity or lipid profiles.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>867 pregnant women with obesity (body mass index \u2265 30 kg\/m2) from the UPBEAT trial (ISRCTN 89971375) were assessed for GDM at 28 weeks\u2019 gestation (75 g oral glucose tolerance test OGTT; World Health Organization criteria). Lipid profiling of the fasting plasma OGTT sample was undertaken using direct infusion mass spectrometry and analyzed by logistic\/linear regression, with and without adjustment for confounders. Insulin secretion and sensitivity were characterized by homeostatic model assessment 2b and 2s, respectively.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>In women who developed GDM (n = 241), patterns of glycaemia were associated with distinct clinical and biochemical characteristics and changes to lipid abundance in the circulation. Severity of glucose derangement, rather than pattern of postload glycaemia, was most strongly related to insulin action and lipid abundance\/profile. Unexpectedly, women with isolated postload hyperglycemia had comparable insulin secretion and sensitivity to euglycemic women, potentially indicative of a novel mechanistic pathway.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Patterns of glycemia during the OGTT may contribute to a precision approach to GDM as assessed by differences in insulin resistance\/secretion. Further research is indicated to determine if isolated postload hyperglycemia reflects a different mechanistic pathway for targeted management.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1210\/clinem\/dgad168","type":"journal-article","created":{"date-parts":[[2023,3,23]],"date-time":"2023-03-23T13:23:58Z","timestamp":1679577838000},"page":"2643-2652","source":"Crossref","is-referenced-by-count":14,"title":["Towards Precision Medicine in Gestational Diabetes: Pathophysiology and Glycemic Patterns in Pregnant Women With Obesity"],"prefix":"10.1210","volume":"108","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7979-0508","authenticated-orcid":false,"given":"Sara L","family":"White","sequence":"first","affiliation":[{"name":"Department of Women and Children\u2019s Health, School of Life Course and Population Sciences, Faculty of Life Sciences and Medicine, King\u2019s College London , London, SE1 7EH , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9998-051X","authenticated-orcid":false,"given":"Albert","family":"Koulman","sequence":"additional","affiliation":[{"name":"Core Metabolomics and Lipidomics Laboratory, Wellcome Trust-MRC Institute of Metabolic Science, University of Cambridge, Addenbrooke\u2019s Treatment Centre , Cambridge, CB2 0QQ , UK"},{"name":"Wellcome Trust-MRC Institute of Metabolic Science, University of Cambridge, Addenbrooke\u2019s Treatment Centre , Cambridge, CB2 0QQ , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8753-5144","authenticated-orcid":false,"given":"Susan E","family":"Ozanne","sequence":"additional","affiliation":[{"name":"Wellcome Trust-MRC Institute of Metabolic Science, University of Cambridge, Addenbrooke\u2019s Treatment Centre , Cambridge, CB2 0QQ , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4267-2051","authenticated-orcid":false,"given":"Samuel","family":"Furse","sequence":"additional","affiliation":[{"name":"Core Metabolomics and Lipidomics Laboratory, Wellcome Trust-MRC Institute of Metabolic Science, University of Cambridge, Addenbrooke\u2019s Treatment Centre , Cambridge, CB2 0QQ , UK"},{"name":"Wellcome Trust-MRC Institute of Metabolic Science, University of Cambridge, Addenbrooke\u2019s Treatment Centre , Cambridge, CB2 0QQ , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucilla","family":"Poston","sequence":"additional","affiliation":[{"name":"Department of Women and Children\u2019s Health, School of Life Course and Population Sciences, Faculty of Life Sciences and Medicine, King\u2019s College London , London, SE1 7EH , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4176-8329","authenticated-orcid":false,"given":"Claire L","family":"Meek","sequence":"additional","affiliation":[{"name":"Core Metabolomics and Lipidomics Laboratory, Wellcome Trust-MRC Institute of Metabolic Science, University of Cambridge, Addenbrooke\u2019s Treatment Centre , Cambridge, CB2 0QQ , UK"},{"name":"Wellcome Trust-MRC Institute of Metabolic Science, University of Cambridge, Addenbrooke\u2019s Treatment Centre , Cambridge, CB2 0QQ , UK"},{"name":"Department of Clinical Biochemistry\/Wolfson Diabetes & Endocrine Clinic, Cambridge University Hospitals NHS Foundation Trust , Cambridge, CB2 0QQ , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"80","published-online":{"date-parts":[[2023,3,23]]},"reference":[{"issue":"7","key":"2024012422164890100_dgad168-B1","doi-asserted-by":"crossref","first-page":"1617","DOI":"10.2337\/dci20-0022","article-title":"Precision medicine in diabetes: a consensus report from the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD)","volume":"43","author":"Chung","year":"2020","journal-title":"Diabetes Care"},{"issue":"6","key":"2024012422164890100_dgad168-B2","doi-asserted-by":"crossref","first-page":"1258","DOI":"10.1007\/s00125-020-05115-6","article-title":"Studies of insulin and proinsulin in pancreas and serum support the existence of aetiopathological endotypes of type 1 diabetes associated with age at diagnosis","volume":"63","author":"Leete","year":"2020","journal-title":"Diabetologia"},{"issue":"8","key":"2024012422164890100_dgad168-B3","doi-asserted-by":"crossref","first-page":"637","DOI":"10.1016\/S2213-8587(18)30106-2","article-title":"Effectiveness and safety of long-term treatment with sulfonylureas in patients with neonatal diabetes due to KCNJ11 mutations: an international cohort study","volume":"6","author":"Bowman","year":"2018","journal-title":"Lancet Diabetes Endocrinol"},{"issue":"5","key":"2024012422164890100_dgad168-B4","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1016\/S2213-8587(18)30051-2","article-title":"Novel subgroups of adult-onset diabetes and their association with outcomes: a data-driven cluster analysis of six variables","volume":"6","author":"Ahlqvist","year":"2018","journal-title":"Lancet Diabetes Endocrinol"},{"issue":"6","key":"2024012422164890100_dgad168-B5","doi-asserted-by":"crossref","first-page":"442","DOI":"10.1016\/S2213-8587(19)30087-7","article-title":"Disease progression and treatment response in data-driven subgroups of type 2 diabetes compared with models based on simple clinical features: an analysis using clinical trial data","volume":"7","author":"Dennis","year":"2019","journal-title":"Lancet Diabetes Endocrinol"},{"key":"2024012422164890100_dgad168-B6","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.diabres.2018.02.031","article-title":"FIGO-IDF joint statement and declaration on hyperglycemia in pregnancy","volume":"145","author":"Sadikot","year":"2018","journal-title":"Diabetes Res Clin Pract"},{"issue":"19","key":"2024012422164890100_dgad168-B7","doi-asserted-by":"crossref","first-page":"1991","DOI":"10.1056\/NEJMoa0707943","article-title":"Hyperglycemia and adverse pregnancy outcomes","volume":"358","author":"Metzger","year":"2008","journal-title":"N Engl J Med"},{"issue":"1","key":"2024012422164890100_dgad168-B8","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1177\/0004563216674743","article-title":"Natural selection? The evolution of diagnostic criteria for gestational diabetes","volume":"54","author":"Meek","year":"2017","journal-title":"Ann Clin Biochem"},{"key":"2024012422164890100_dgad168-B9","author":"National Institute for Health and Care Excellence."},{"issue":"6","key":"2024012422164890100_dgad168-B10","doi-asserted-by":"crossref","first-page":"1052","DOI":"10.2337\/dc15-2672","article-title":"Heterogeneous contribution of insulin sensitivity and secretion defects to gestational diabetes mellitus","volume":"39","author":"Powe","year":"2016","journal-title":"Diabetes Care"},{"issue":"1","key":"2024012422164890100_dgad168-B11","doi-asserted-by":"crossref","first-page":"268","DOI":"10.2337\/db20-0772","article-title":"Genetic loci and physiologic pathways involved in gestational diabetes mellitus implicated through clustering","volume":"70","author":"Powe","year":"2021","journal-title":"Diabetes"},{"issue":"1","key":"2024012422164890100_dgad168-B12","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1016\/j.pcd.2021.08.006","article-title":"Unifying the diagnosis of gestational diabetes mellitus: introducing the NPRP criteria","volume":"16","author":"Doi","year":"2022","journal-title":"Prim Care Diabetes"},{"issue":"7","key":"2024012422164890100_dgad168-B13","doi-asserted-by":"crossref","first-page":"e2825","DOI":"10.1210\/clinem\/dgac206","article-title":"Altered lipid metabolism in obese women with gestational diabetes and associations with offspring adiposity","volume":"107","author":"Furse","year":"2022","journal-title":"J Clin Endocrinol Metab"},{"issue":"1","key":"2024012422164890100_dgad168-B14","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1111\/dme.14173","article-title":"Elevated fasting vs post-load glucose levels and pregnancy outcomes in gestational diabetes: a population-based study","volume":"37","author":"Ryan","year":"2020","journal-title":"Diabet Med"},{"key":"2024012422164890100_dgad168-B15","author":"Public Health England","year":"2019."},{"issue":"10","key":"2024012422164890100_dgad168-B16","doi-asserted-by":"crossref","first-page":"767","DOI":"10.1016\/S2213-8587(15)00227-2","article-title":"Effect of a behavioural intervention in obese pregnant women (the UPBEAT study): a multicentre, randomised controlled trial","volume":"3","author":"Poston","year":"2015","journal-title":"Lancet Diabetes Endocrinol"},{"key":"2024012422164890100_dgad168-B17","article-title":"Analytical information for UPBEAT sample preparation.","author":"Meek"},{"issue":"7","key":"2024012422164890100_dgad168-B18","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0006261","article-title":"Top-down lipidomics reveals ether lipid deficiency in blood plasma of hypertensive patients","volume":"4","author":"Graessler","year":"2009","journal-title":"PLoS One"},{"issue":"6","key":"2024012422164890100_dgad168-B19","doi-asserted-by":"crossref","first-page":"420","DOI":"10.1039\/C9MO00117D","article-title":"Altered triglyceride and phospholipid metabolism predates the diagnosis of gestational diabetes in obese pregnancy","volume":"15","author":"Furse","year":"2019","journal-title":"Mol Omics"},{"issue":"6","key":"2024012422164890100_dgad168-B20","doi-asserted-by":"crossref","first-page":"2397","DOI":"10.1021\/acs.jproteome.8b00786","article-title":"An unbiased lipid phenotyping approach to study the genetic determinants of lipids and their association with coronary heart disease risk factors","volume":"18","author":"Harshfield","year":"2019","journal-title":"J Proteome Res"},{"key":"2024012422164890100_dgad168-B21","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1186\/1471-2393-14-74","article-title":"A complex intervention to improve pregnancy outcome in obese women; the UPBEAT randomised controlled trial","volume":"14","author":"Briley","year":"2014","journal-title":"BMC Pregnancy Childbirth"},{"issue":"1","key":"2024012422164890100_dgad168-B22","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1186\/s13059-018-1439-8","article-title":"Hepatic steatosis risk is partly driven by increased de novo lipogenesis following carbohydrate consumption","volume":"19","author":"Sanders","year":"2018","journal-title":"Genome Biol"},{"issue":"5","key":"2024012422164890100_dgad168-B23","doi-asserted-by":"crossref","first-page":"e1871","DOI":"10.1210\/clinem\/dgac041","article-title":"Oral glucose tolerance test-based measures of insulin secretory response in pregnancy","volume":"107","author":"Powe","year":"2022","journal-title":"J Clin Endocrinol Metab"},{"issue":"5","key":"2024012422164890100_dgad168-B24","doi-asserted-by":"crossref","first-page":"1130","DOI":"10.2337\/dc05-2179","article-title":"Contributions of beta-cell dysfunction and insulin resistance to the pathogenesis of impaired glucose tolerance and impaired fasting glucose","volume":"29","author":"Abdul-Ghani","year":"2006","journal-title":"Diabetes Care"},{"issue":"3","key":"2024012422164890100_dgad168-B25","doi-asserted-by":"crossref","first-page":"365","DOI":"10.1530\/REP-10-0088","article-title":"Obesity, insulin resistance, and pregnancy outcome","volume":"140","author":"Catalano","year":"2010","journal-title":"Reproduction"},{"issue":"1","key":"2024012422164890100_dgad168-B26","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/0009-3084(94)90024-8","article-title":"Phases and phase transitions of the hydrated phosphatidylethanolamines","volume":"69","author":"Koynova","year":"1994","journal-title":"Chem Phys Lipids"},{"issue":"1","key":"2024012422164890100_dgad168-B27","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1016\/S0304-4157(98)00006-9","article-title":"Phases and phase transitions of the phosphatidylcholines","volume":"1376","author":"Koynova","year":"1998","journal-title":"Biochim Biophys Acta"},{"key":"2024012422164890100_dgad168-B28","doi-asserted-by":"crossref","first-page":"134","DOI":"10.1016\/j.cca.2022.12.005","article-title":"Metabolomics in gestational diabetes mellitus: a review","volume":"539","author":"Xie","year":"2022","journal-title":"Clin Chim Acta"},{"issue":"9","key":"2024012422164890100_dgad168-B29","doi-asserted-by":"crossref","first-page":"1783","DOI":"10.1007\/s00125-020-05198-1","article-title":"Metabolomic and genetic associations with insulin resistance in pregnancy","volume":"63","author":"Liu","year":"2020","journal-title":"Diabetologia"},{"key":"2024012422164890100_dgad168-B30","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1016\/j.cca.2016.12.010","article-title":"Unsaturated plasma phospholipids are consistently lower in the patients diagnosed with gestational diabetes mellitus throughout pregnancy: a longitudinal metabolomics study of Chinese pregnant women part 1","volume":"465","author":"Law","year":"2017","journal-title":"Clinica Chimica Acta"},{"issue":"3-4","key":"2024012422164890100_dgad168-B31","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1159\/000365028","article-title":"Placental fatty acid transfer: a key factor in fetal growth","volume":"64","author":"Larque","year":"2014","journal-title":"Ann Nutr Metab"},{"issue":"7","key":"2024012422164890100_dgad168-B32","doi-asserted-by":"crossref","first-page":"E826","DOI":"10.1152\/ajpendo.00291.2013","article-title":"Materno-fetal transfer of docosahexaenoic acid is impaired by gestational diabetes mellitus","volume":"305","author":"Pagan","year":"2013","journal-title":"Am J Physiol Endocrinol Metab"},{"issue":"10","key":"2024012422164890100_dgad168-B33","doi-asserted-by":"crossref","first-page":"1903","DOI":"10.1007\/s00125-017-4380-6","article-title":"Metabolic profiling of gestational diabetes in obese women during pregnancy","volume":"60","author":"White","year":"2017","journal-title":"Diabetologia"}],"container-title":["The Journal of Clinical Endocrinology &amp; Metabolism"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/jcem\/advance-article-pdf\/doi\/10.1210\/clinem\/dgad168\/49879474\/dgad168.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jcem\/article-pdf\/108\/10\/2643\/56405562\/dgad168.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jcem\/article-pdf\/108\/10\/2643\/56405562\/dgad168.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,1,24]],"date-time":"2024-01-24T22:17:34Z","timestamp":1706134654000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jcem\/article\/108\/10\/2643\/7084352"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,3,23]]},"references-count":33,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2023,3,23]]},"published-print":{"date-parts":[[2023,9,18]]}},"URL":"https:\/\/doi.org\/10.1210\/clinem\/dgad168","relation":{},"ISSN":["0021-972X","1945-7197"],"issn-type":[{"value":"0021-972X","type":"print"},{"value":"1945-7197","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2023,10]]},"published":{"date-parts":[[2023,3,23]]}}}