2019 has revealed more evidence for the detrimental effects to offspring of in-utero exposure to maternal hyperglycemia. The Hyperglycemia and Adverse Pregnancy Outcome (HAPO) Follow-up study has revealed that increasing maternal glycemia in pregnancy is associated with worsening childhood glucose metabolism persisting into early adolescence. Longitudinal data from the ESTER and AYLS cohort studies have shown that maternal pre-pregnancy overweight and GDM are associated with unhealthy body size and composition in offspring over 20 years later. The association between glycaemia in pregnancy and stillbirth was highlighted by a case-control study from the UK which found a four-fold greater risk of late stillbirth in women with raised fasting plasma glucose but not diagnosed with GDM. Observational studies have also suggested a link between maternal dysglycemia in pregnancy and autism and ADHD.
Advances in technology were also featured in the 2018/19 literature. Studies on the use of flash glucose monitoring, intermittent continuous glucose monitoring and closed-loop insulin delivery in pregnancy will be reviewed.
Precision medicine in diabetes in pregnancy was also topical in 2018/19 with many studies aiming to identify biomarkers predictive of future gestational diabetes, complications of diabetes in pregnancy and future risk of diabetes in women with prior GDM. Highlights from this literature will be presented.