Agata's Interview & Publication

What inspired your research and what did it cover?
Gestational diabetes (GDM) is one of the most common conditions during pregnancy with prevalence reaching 20% in some countries. The condition not only affects the immediate health of the mother and foetus but also increases the long-term risk of type 2 diabetes mellitus, cardiovascular disease and metabolic syndrome in both mother and child. Insulin resistance (IR), a decreased ability of target tissues such as the liver, adipose tissue and muscle to respond to normal circulating concentrations of insulin is thought to contribute to the aetiology of GDM. Studies have shown that low vitamin B12 and high folate status are associated with GDM and IR. Unlike in previous studies, we used a comprehensive panel of vitamin B12 and folate markers, many of which were developed in our laboratory, to examine these associations in pregnant women of Bangladeshi origin.

Looking at the potential of your findings, what difference can they make? 
We found that low vitamin B12 and high folate status are associated with insulin resistance during the third trimester of pregnancy and may contribute to GDM risk.  This is important as the UK Government and devolved administrations announced in September 2021 their intention to proceed with arrangements to require the mandatory fortification of non-wholemeal wheat flour with folic acid (a synthetic form of folate) to help prevent neural tube defects in foetuses. This initiative will partially reduce the prevalence of neural tube defects, but it may also increase the risk of GDM since vitamin B12 deficiency is common in pregnancy. We also demonstrated that markers of vitamin B12 need to be carefully interpreted given pregnancy-related changes affecting its concentrations. Because the provision of balanced and adequate vitamin B12 and folate is vital for the well-being of both mother and child, we recommend that pregnancy-specific reference ranges should be used for all B12 markers.