Dr. Marla: Gestational Diabetes and Diabetes in Children
Published Tuesday, August 26, 2014 8:40AM EDT
Last Updated Tuesday, August 26, 2014 8:46AM EDT
Gestational diabetes: What exactly is that? Just slightly less than 10 per cent of pregnant women who have normal blood sugars entering the pregnancy will develop issues with blood sugar during their pregnancy - or gestation - and develop what is called gestational diabetes.
That is why we routinely test for it in pregnancy - at around 24 weeks or so. We do know that women over age 25 when pregnant, those who have a personal or family history and those who are overweight are more at risk of developing this condition. We do know that it can impact the mother in later years and she herself is at higher risk to develop frank diabetes. But does gestational diabetes have an impact on the pregnancy and the child delivered of the pregnancy?
Indeed it does! New research published in Diabetologia (the journal of the European Association for the Study of Diabetes) studied children exposed to gestational diabetes in the wombs of their mothers and found that these children, years later in adolescence, are around SIX times more likely to develop diabetes or pre-diabetes than children not exposed to gestational diabetes when in utero. The study was done through Yale University School of Medicine.
The authors hypothesized that prenatal exposure to moms with gestational diabetes would impact their offspring. The study looked at obese children with normal glucose tolerance in early adolescence and previous exposure to gestational diabetes. The authors thought they would be associated with development of altered glucose metabolism over time as they got older. This was thought to result because the beta cells in the pancreas that are responsible for insulin production as well as how effective the insulin would work might be impaired by this exposure.
Indeed, the authors did find this association. The authors found that 210 offspring (82 per cent) were not exposed to gestational DM , and 45 (18 per cent) were exposed to gestational DM . In the group not exposed to mom's with gestational diabetes, only 9 per cent developed impaired glucose tolerane or frank type 2 diabetes as compared with 31 per cent of the exposed group who developed either issues with glucose tolerance or type 2 diabetes.
The study demonstrates that obese normal glucose-tolerant children of mothers with gestational diabetes have a strong risk factor for these children to develop pre-diabetes or diabetes.
There is an ever growing number of women with gestational diabetes which makes this information so important.
The advice is that entering into pregnancy it is important to follow a healthy lifestyle and lose any excess weight. And for the offspring of mothers with gestational diabetes, a case can be made for them to be screened for impaired fasting glucose , pre-diabetes and diabetes in mid puberty and perhaps later on again.
While not all cases of gestational diabetes can be prevented, they can be treated effectively during pregnancy. Healthy lifestyle and appropriate weight should be encouraged in all offspring and particularly these at risk offspring.