Gestational diabetes & diabetes in pregnancy
Maternal Gut Microbiome as a Predictor of Insulin Therapy Requirement in Gestational Diabetes
Authors' conclusion
Our findings demonstrate that integrating gut microbiome characteristics with clinical data improves the prediction of insulin treatment needs in GDM, particularly for BI initiation.
Study context
- Population
- Pregnant women with gestational diabetes mellitus (GDM) from the Genetic and Epigenetic Mechanisms of Developing Gestational Diabetes Mellitus and its Effects on the Fetus study
- Participants
- 205 women
- Comparison
- Clinical plus gut microbiome data vs clinical data alone for predicting insulin therapy
- Outcome
- Prediction of need for insulin therapy (IT), assessed by repeated stratified five-fold cross-validated AUC-ROC
Methodological detailsmachine learning (gradient boosting), nested cross-validation, 16S rRNA gene sequencing
- Machine learning (gradient boosting)
- Nested cross-validation
- 16S rRNA gene sequencing
Performance
As reported in the abstract
AUC-ROC for IT prediction
Adding microbiome data improved area under the curve-receiver operating characteristic (AUC-ROC) for insulin therapy (IT) prediction from 0.63 (95% CI 0.43, 0.83) to 0.70 (0.50, 0.89)
0.63 to 0.70
Further findings
AUC-ROC for basal insulin (BI) prediction
- Adding microbiome data improved AUC-ROC for BI from 0.77 (0.59, 0.95) to 0.82 (0.65, 0.99)
- 0.77 to 0.82
AUC-ROC for prandial insulin (PI) prediction
- Adding microbiome data improved AUC-ROC for PI from 0.69 (0.50, 0.88) to 0.70 (0.51, 0.89)
- 0.69 to 0.70
Clinical characteristics, insulin vs diet-treated
- Women requiring insulin were older and had higher pre-pregnancy body mass index (BMI), FPG, 1-h OGTT glucose and HbA1c than diet-treated women
- P < 0.05 for all
Key influential features
- Glycemic markers, BMI and microbial taxa (Phascolarctobacterium faecium, Alistipes ihumii, Cloacibacillus evryensis, Ruthenibacterium lactatiformans, Methanosphaera stadtmanae) and predicted pathway PWY-5823
Original publication
Maternal Gut Microbiome as a Predictor of Insulin Therapy Requirement in Gestational Diabetes. J Diabetes Sci Technol. Published 4 March 2026. doi:10.
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