Mother’s gestational diabetes puts children at risk

Children born to women who had gestational diabetes have a substantially higher likelihood of developing diabetes as teenagers, a new study shows.

The researchers followed 255 obese adolescents over the course of roughly three years, about one in five of whom had been exposed to gestational diabetes in the womb.

At the start of the study, published in the journal Diabetologia, tests showed that all of the adolescents had normal glucose tolerance.

But three years later, teenagers born to mothers with gestational diabetes were six times more likely to have progressed to pre-diabetes or diabetes themselves than those born to mothers without the condition.

PHYSIOLOGICAL FACTORS
Children exposed to gestational diabetes already had signs of reduced function in the insulin-producing beta cells of the pancreas at the study’s start, said Dr Sonia Caprio, a study author and professor of paediatric endocrinology at Yale.

She suspects there may be environmental factors at play in the first few years of life, or unique epigenetic changes in the womb that impair beta cell function.

The findings are particularly concerning because gestational diabetes is on the rise in the United States.

“We need to reduce the onset of gestational diabetes,” Caprio said. “There is a lot of focus on trying to prevent women from gaining a lot of weight during pregnancy. Not only could it prevent the onset of diabetes in the woman, but in the child as well.”

Meanwhile, another study has found that African-Americans born at low birth weight are at an increased risk for Type 2 diabetes later in life.

HIGH RISK VICTIMS
Researchers at Boston University School of Public Health followed more than 21,000 women ages 21 to 69, who were enrolled in a large study of African-American women’s health for 16 years. Some 2,388 of them developed Type 2 diabetes.

After controlling for age, family history of diabetes, weight, socioeconomic status and other factors, they found that girls born at 5.5 pounds or less were 13 per cent more likely to be found to have Type 2 diabetes later in life, compared with babies born at normal weight.

Girls born at less than 3.3 pounds were 40 per cent more likely to develop the disease, the researchers found. Their study appears in the September issue of Diabetes Care.

The link has been found in other populations, but black women have a higher frequency of low birth weight and a higher incidence of Type 2 diabetes than women in other ethnic groups.

LOW BIRTH WEIGHT

The authors suggest that low birth weight may lead to problems in lipid regulation and pancreatic function. There is also some evidence that low birth weight and diabetes share a genetic basis.
“The advice to have a healthy lifestyle - exercising, maintaining healthy weight and a healthy diet - applies to the whole population,” said the lead author, Dr Edward Ruiz-Narváez, an assistant professor of epidemiology at the university.

“But I would say that women with low-birth-weight babies should pay special attention to these lifestyle factors.