Ever growing number of women with gestational diabetes suggests future will be filled with children with early diabetes

August 25, 2014

New research published in Diabetologia (the journal of the European Association for the Study of Diabetes) shows that children exposed to gestational diabetes in the wombs of their mothers are themselves around six times more likely to develop diabetes or prediabetes than children not exposed. The research is by Dr Sonia Caprio, Yale University School of Medicine, New Haven, CT, USA, and colleagues.

With the increase in gestational diabetes (GDM), there is a growing need to understand the effects of glucose exposure on the newborn in the womb, at birth and later in life. The risk of developing impaired glucose tolerance (IGT) (prediabetes) in individuals exposed to diabetes in the womb has not, say the authors, been adequately investigated. Thus in this new study, the authors examined the risk in obese youths of developing IGT after exposure to GDM in the womb. The authors say: "We hypothesised that prenatal exposure to GDM in obese children with normal glucose tolerance (NGT) would be associated with development of altered glucose metabolism over time, driven by an impairment of beta cell secretion relative to the insulin sensitivity."

255 obese adolescents with a normal glucose tolerance were selected for the study. All of them were investigated for in utero exposure to GDM and underwent an OGTT, which was repeated after approximately 3 years. The authors found that 210 (82%) participants were not exposed to GDM (called the NGDM group), and 45 (18%) were exposed to GDM (the EGDM group). In the NGDM group, only 9% (n=18) developed either IGT or type 2 diabetes compared with 31% (n=14) of the EGDM group who developed either IGT or type 2 diabetes, with both results statistically significant.. "Exposure to GDM was the most significant predictor of developing IGT or type 2 diabetes, with an increased risk of almost six times for those children exposed to GDM in the womb," say the authors.

At baseline, the EGDM group showed a reduction in beta cell function (the cells that produce insulin), and, at follow-up, they also displayed a reduction in insulin sensitivity compared with the NGDM group.

"Our study demonstrates that obese normal glucose-tolerant children of GDM mothers have pre-existing defects in beta cell function," say the authors. "This is in turn a strong risk factor for these children to develop prediabetes or diabetes."

They add: "The ever growing number of women with gestational diabetes (18%) suggests that the future will be filled with children with early diabetes at a rate that far exceeds the current prevalence."

They conclude: " Offspring of GDM mothers ought to be screened for IGT and/or impaired fasting glucose (another form of prediabetes), and preventive and therapeutic strategies should be considered before the development of full clinical manifestation of diabetes. While we cannot use this analysis for development of definitive screening guidelines, we strongly suggest that, among obese children and adolescents exposed to GDM, specifically if additional risk factors are present--such as severe obesity or being of ethnicity minorities at higher risk--oral glucose tolerance tests should be performed at baseline (specifically in mid-pubertal adolescents) and potentially repeated based on clinical judgement. Furthermore, the need for studies aimed at unravelling the role of genetic or epigenetic factors and environmental postnatal factors that might be causing functional defects in the beta cell has never been more urgent."
-end-


Diabetologia

Related Diabetes Articles from Brightsurf:

New diabetes medication reduced heart event risk in those with diabetes and kidney disease
Sotagliflozin - a type of medication known as an SGLT2 inhibitor primarily prescribed for Type 2 diabetes - reduces the risk of adverse cardiovascular events for patients with diabetes and kidney disease.

Diabetes drug boosts survival in patients with type 2 diabetes and COVID-19 pneumonia
Sitagliptin, a drug to lower blood sugar in type 2 diabetes, also improves survival in diabetic patients hospitalized with COVID-19, suggests a multicenter observational study in Italy.

Making sense of diabetes
Throughout her 38-year nursing career, Laurel Despins has progressed from a bedside nurse to a clinical nurse specialist and has worked in medical, surgical and cardiac intensive care units.

Helping teens with type 1 diabetes improve diabetes control with MyDiaText
Adolescence is a difficult period of development, made more complex for those with Type 1 diabetes mellitus (T1DM).

Diabetes-in-a-dish model uncovers new insights into the cause of type 2 diabetes
Researchers have developed a novel 'disease-in-a-dish' model to study the basic molecular factors that lead to the development of type 2 diabetes, uncovering the potential existence of major signaling defects both inside and outside of the classical insulin signaling cascade, and providing new perspectives on the mechanisms behind insulin resistance in type 2 diabetes and possibly opportunities for the development of novel therapeutics for the disease.

Tele-diabetes to manage new-onset diabetes during COVID-19 pandemic
Two new case studies highlight the use of tele-diabetes to manage new-onset type 1 diabetes in an adult and an infant during the COVID-19 pandemic.

Genetic profile may predict type 2 diabetes risk among women with gestational diabetes
Women who go on to develop type 2 diabetes after having gestational, or pregnancy-related, diabetes are more likely to have particular genetic profiles, suggests an analysis by researchers at the National Institutes of Health and other institutions.

Maternal gestational diabetes linked to diabetes in children
Children and youth of mothers who had gestational diabetes during pregnancy are at increased risk of diabetes themselves, according to new research published in CMAJ (Canadian Medical Association Journal).

Two diabetes medications don't slow progression of type 2 diabetes in youth
In youth with impaired glucose tolerance or recent-onset type 2 diabetes, neither initial treatment with long-acting insulin followed by the drug metformin, nor metformin alone preserved the body's ability to make insulin, according to results published online June 25 in Diabetes Care.

People with diabetes visit the dentist less frequently despite link between diabetes, oral health
Adults with diabetes are less likely to visit the dentist than people with prediabetes or without diabetes, finds a new study led by researchers at NYU Rory Meyers College of Nursing and East Carolina University's Brody School of Medicine.

Read More: Diabetes News and Diabetes Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.