Gestational Diabetes May Raise Diabetes Risk in Kids

Diabetes and prediabetes were more likely to develop in children exposed to gestational diabetes in the womb

(RxWiki News) Gestational diabetes, which occurs during pregnancy, has been on the rise. As more expectant women get high blood sugar, more children may also face the threat of getting the disease.

In some pregnant women, hormones prevent insulin from doing its job. Insulin helps cells throughout the body absorb glucose (blood sugar) and use it for energy.

Gestational diabetes usually goes away after pregnancy. Researchers recently found, however, that children whose mothers had gestational diabetes had a high likelihood of having above-normal blood sugar levels.

"If you had gestational diabetes, consider having your child tested for diabetes."

"Diabetes, regardless of the specific type, is improved significantly by simply controlling one's weight. By achieving a BMI of 25 or less prior to pregnancy, it is possible in many circumstances to significantly reduce the risk of gestational diabetes," said Andre Hall, MD, an OB-GYN at Birth and Women's Care, PA in Fayetteville, NC.

"Once pregnant, if an individual is given a diagnosis of gestational diabetes mellitus, it is imperative to eat meals of under 2,000 calories and to monitor one's blood sugar. Whether or not a patient requires insulin will in part be dictated by how well an individual controls the disease process," said Dr. Hall, who was not involved in this study.

"Uncontrolled blood sugars while pregnant are dangerous for mom but are more dangerous to the developing child," he told dailyRx News.

This study was conducted by Sonia Caprio, MD, professor of pediatrics at Yale University School of Medicine in New Haven, CT, and colleagues.

They followed 255 obese adolescents who had normal glucose tolerance, which means their bodies broke down glucose normally. Obesity has been shown to increase the risk for Type 2 diabetes.

Of these individuals, 210 (or 82 percent) were not exposed to gestational diabetes and 45 (18 percent) were.

At the start of the study, all received an oral glucose tolerance test. This tests for impaired glucose tolerance, a type of prediabetes. They were tested again about three years later.

Prediabetes means that blood sugar levels are elevated but not yet high enough to be considered diabetes.

In the group whose mothers did not have gestational diabetes, 9 percent developed either prediabetes or Type 2 diabetes. Among those who had mothers with gestational diabetes, almost 1 in 3 developed either prediabetes or Type 2 diabetes.

With Type 2 diabetes, the cells fail to properly use insulin. This is called insulin resistance. Beta cells in the pancreas may try to produce more insulin, but, over time, they may not be able to produce enough. In Type 1 diabetes, the pancreas produces little or no insulin. If left untreated, either type of diabetes can lead to high blood sugar. High blood sugar increases the risk of heart attack, stroke, nerve damage, kidney problems and other health issues.

Dr. Caprio and her team calculated that the risk of getting either Type 2 diabetes or prediabetes increased almost six times for children who were exposed to gestational diabetes in the womb.

The authors noted that those in the gestational diabetes group had shown below-normal function of their beta cells (the cells that produce insulin) at the start of the study. This reduced beta cell function persisted at follow-up.

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

They recommended that obese children of mothers who had gestational diabetes be screened for prediabetes.

“Preventive and therapeutic strategies should be considered before the development of full clinical manifestation of diabetes,” they wrote.

The researchers added that the number of pregnant women who experienced gestational diabetes was high — around 18 percent. This suggested that the number of children who reached higher-than-normal blood sugar levels would increase as well.

The study was published Aug. 25 in Diabetologia.

The authors declared no conflicts of interest.

Review Date: 
August 25, 2014