E-news: Growth of gestational diabetes suggests more children with early diabetes

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 study in the journal Diabetologia 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, led by Dr Sonia Caprio, Yale University School of Medicine, New Haven, 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.

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."

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