Biomarkers of Gestational Diabetes Mellitus: Mechanisms, Advances, and Clinical Utility
Abstract
Gestational diabetes mellitus (GDM) continues to pose a significant challenge to maternal and fetal health, driving the need for advanced diagnostic and therapeutic strategies. Biomarker discovery has proven essential for early detection, mechanistic insights, and targeted interventions. This review provides an in-depth examination of biomarkers related to GDM, focusing on glucose metabolism, insulin resistance, inflammatory signaling, adipokines, oxidative stress markers, and genetic/epigenetic determinants. We also evaluate novel biomarkers emerging from omics technologies and their translational potential in clinical practice. Additionally, we explore the role of microRNAs and extracellular vesicles as emerging biomarkers that could offer new perspectives on GDM pathophysiology. Integration of these biomarkers into predictive models holds the potential to improve risk assessment and patient health outcomes.
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Placental and circulating miRNAs can modulate gene expression through epigenetic mechanisms and may alter key developmental pathways including PPAR, mTOR, WNT, and insulin/IGF signaling.
“Importantly, placental and circulating miRNAs can modulate gene expression through epigenetic mechanisms and may alter key developmental pathways, including PPAR, mTOR, WNT, and insulin/IGF signaling, thereby influencing fetal growth patterns and long-term disease risk [41,43,44,45].”
From Maternal Overnutrition and Fetal Programming: Long-Term Metabolic, Cognitive, and Epigenetic Consequences (2026) · cites this paper as [45]
Circulating miRNAs dysregulated in GDM are implicated in inflammation, endothelial dysfunction, lipid and glucose metabolism, and insulin signaling.
“Several miRNAs dysregulated in GDM have been implicated in inflammation, endothelial dysfunction, lipid and glucose metabolism, and insulin signaling.”
From Maternal Overnutrition and Fetal Programming: Long-Term Metabolic, Cognitive, and Epigenetic Consequences (2026) · cites this paper as [45]
Cites
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“27,73 This disruption of insulin pathways is a core feature of GDM and exacerbates glucose intolerance.”
Kynurenine pathway of tryptophan metabolism: regulatory and functional aspects
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Schiera, G., Macajone, G., Volpes, S., Greco, L., Di Liegro, C. M., Serio, G., Caradonna, F., & Naselli, F. (2026) · Cells · doi:10.3390/cells15040366 · Cited by 8 · see citing works
- Authors
- Pramodkumar, T. A., Hannah, W., Anjana, R. M., Ram, U., Tiwaskar, M., Gokulakrishnan, K., Popova, P. V., & Mohan, V.
- Affiliations
- Madras Diabetes Research Foundation (IN)
- Seethapathy Clinic and Hospital (IN)
- National Institute of Mental Health and Neurosciences (IN)
- Federal Almazov North-West Medical Research Centre (RU)
- ORCID
- Venue
- Journal of The Association of Physicians of India
- Publisher
- Jaypee Brothers Medical Publishing
- Published
- 2025-02
- Volume
- 73
- Issue
- 2
- Pages
- 56-67
- ISSN
- 0004-5772 (ISSN-L)
- OpenAlex
- W4407348603
- Cited by
- 7
- References
- 5
- Citations by year
- 2026: 4 · 2025: 3
- FWCI
- 1.54
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of the Association of Physicians of India (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Obstetrics and Gynecology › Gestational Diabetes Research and Management
- Health Sciences › Medicine › Obstetrics and Gynecology › Pregnancy and preeclampsia studies
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Birth, Development, and Health
- Keywords
- gestational diabetes mellitus, biomarkers, glucose metabolism, insulin resistance, inflammation, adipokines, oxidative stress, epigenetics, omics, microRNA, extracellular vesicles, risk prediction, early diagnosis
- MeSH terms
- Female, Humans, Insulin Resistance, Pregnancy, Biomarkers, Diabetes, Gestational, Oxidative Stress, MicroRNAs, Adipokines
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