Children exposed to gestational diabetes in the wombs of their mothers are six times more likely to develop diabetes or prediabetes than children not exposed, according to new research from Yale University School of Medicine.
The study, published in Diabetologia (the journal of the European Association for the Study of Diabetes), evaluated the effects of glucose exposure on a newborn in the womb, at birth and later in life. Prior to this investigation, an individual's risk of developing prediabetes after being in contact with diabetes in the womb had not been sufficiently researched.
Gestational diabetes occurs in women who have never had diabetes before but develop high blood glucose levels during pregnancy. About 1 in 10 pregnant women get gestational diabetes (GDM), according to the American Diabetes Association.
For the study, 255 obese adolescents with normal glucose tolerance were examined for in utero exposure to GDM. They were tested for prediabetes and diabetes, and the same glucose tolerance test was administered after roughly three years.
Exposed children run higher risk
The results showed that 82 percent of participants were not exposed to GDM and the remaining 18 percent were exposed to GDM. In those whose mothers did have gestational diabetes during pregnancies, 31 percent went on to develop either diabetes or impaired glucose tolerance (IGT), compared to only 9 percent who were not exposed to gestational diabetes. The 20-percent difference proved to be statistically significant, the researchers explained.
Dr. Sonia Caprio, from Yale University, said that the GDM-exposed group had a reduction in beta cell function, which are the cells that produce insulin. They also had a lowered insulin sensitivity compared to the other group.
"Our study demonstrates that obese normal glucose-tolerant children of GDM mothers have pre-existing defects in beta cell function," the authors said in a press release. "This is in turn a strong risk factor for these children to develop prediabetes or diabetes."
Prediabetes expected to surge
With the rising number of women with gestational diabetes (18 percent), Caprio predicts children will have early diabetes at a rate far greater than the current prevalence. She elaborated that steps have to be taken in order to keep these levels in check.
"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," the doctor said.
Caprio said she strongly suggests that obese children and adolescents exposed to GDM should perform oral glucose tolerance tests at baseline, and potentially have them repeated based on their doctors' judgment. Additional risk factors such as severe obesity and belonging to an ethnic minority only heighten the need for these screenings, since these individuals tend to be more susceptible to diabetes.
Better understanding of beta cell defects
Overall, the study underlined the urgency of more tests aimed at decoding the role of genetic or epigenetic factors and environmental postnatal factors that might be causing defects in the beta cells.
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