Editorial: Recent advances in gestational diabetes: diagnosis, treatment and prevention

pregnant women to several obstetric and perinatal complications and places the mother and infant at risk of long-term metabolic morbidity (2). Traditionally, GDM is diagnosed using an oral glucose tolerance test (OGTT) after 24 weeks of gestation. The current practice of GDM testing is relatively late in pregnancy, potentially limiting the opportunity for early interventions to prevent adverse pregnancy outcomes, especially among high-risk population groups. In fact, there is emerging evidence to suggest deleterious effects of 'intermediate hyperglycemia' in early pregnancy, and early therapeutic intervention could potentially reduce several serious neonatal complications (3,4). These observations emphasize the need for a reliable test to predict or diagnose GDM in early pregnancy.Several glycemic markers, including glycated hemoglobin (HbA1c) and fasting plasma glucose, serve as potential diagnostic markers for GDM and have been extensively studied (5). Less studied glycemic markers include 1,5-anhydroglucitol (1,5-AG), CD59 (pGCD59), secondtrimester glycated albumin, and fructosamine levels (6,7). Among these biomarkers, only HbA1c seems promising and could be an early marker for GDM. Currently, there is growing interest in identifying non-glycemic biomarkers for GDM prediction in early pregnancy. These biomarkers relate to pathogenetic events in GDM development: especially, insulin resistance and pancreatic β-cell dysfunction, caused by various factors like placental hormones, inflammation, metabolic changes, genetics, and epigenetic changes (8). The non-glycemic biomarkers under evaluation include adipokines, inflammatory and immunological markers, placenta-derived markers, thyroid function and lipid profile markers, hematological markers, and genetic markers (8).In the present research topic, 'Recent Advances in Gestational Diabetes: Diagnosis, Treatment, and Prevention, three articles focused on the association of GDM with non-glycemic biochemical parameters in early pregnancy: serum pancreatic duodenal homeobox-1 (PDX1) gene, ferritin, and bile acids.PDX1 is a nuclear factor that has a pivotal role in the differentiation of β-cells and is a promoter of the insulin gene expression, thereby increasing the synthesis of insulin and maintaining glucose homeostasis (9,10). In a prospective study, Zhang Q et al. assessed serum PDX-1 levels at 8-12 gestational weeks among 231 pregnant Chinese women and assessed their association with GDM. PDX1 in early pregnancy was negatively correlated with fasting and 2h plasma glucose, HOMA-IR, and the triglyceride-glucose (TyG) index, and positively correlated with HOMA-β in mid-pregnancy (P