Timing of gestational diabetes diagnosis: a novel precision approach to hyperglycaemia in pregnancy?

Precision medicine has offered new opportunities to improve diagnosis, prognostication and management of type 1 diabetes and type 2 diabetes but is relatively unexplored in gestational diabetes. The results of the recent Treatment of Booking Gestational Diabetes Mellitus (TOBOGM) trial suggests that the timing of diagnosis may identify clinically relevant subtypes of gestational diabetes.1 We, here, discuss the rationale, practicalities and translational opportunities of a precision approach to gestational diabetes, which incorporates the timing of diagnosis ('early' being before 20-24weeks; 'late' being after 24 weeks).