Tag Archives: Pregnancy

Diabetes Can Be Predicted 7 Years Before Pregnancy With Blood Sugar And Body Weight

A woman’s risk of developing diabetes during pregnancy can be identified up to seven years before she becomes pregnant based on routinely assessed measures of blood sugar and body weight, according to a Kaiser Permanente study published in the online issue of the American Journal of Obstetrics and Gynecology.

Researchers at the Kaiser Permanente Division of Research in Oakland, Calif., studied 580 ethnically diverse women who took part in a multiphasic health checkup at Kaiser Permanente Northern California between1984 and 1996. The researchers looked at women who had a subsequent pregnancy and compared those who developed gestational diabetes mellitus (GDM) during pregnancy to women who did not have GDM.

The study found that the risk of GDM increased directly with the number of adverse risk factors commonly associated with diabetes and heart disease (high blood sugar, hypertension and being overweight) present before pregnancy. In addition, the authors found that adverse levels of blood sugar and body weight were associated with a 4.6-fold increased risk of GDM, compared to women with normal levels.

The study is among the first to look at routinely measured cardio-metabolic risk factors before pregnancy in women who later became pregnant and developed GDM. The research provides evidence to support pre-conception care for healthy pregnancies as noted in a 2006 report by the Centers for Disease Control and Prevention. That report suggested that risk factors for adverse outcomes among women and infants can be identified prior to conception and are characterized by the need to start, and sometimes finish, interventions before conception occurs.

Women who develop GDM during pregnancy are more likely to develop Type 2 diabetes after pregnancy, previous research has shown. GDM is defined as glucose intolerance that typically occurs during the second or third trimester and causes complications in as much as 7 percent of pregnancies in the United States. It can lead to early delivery and Cesarean sections, and increases the baby’s risk of developing diabetes, obesity and metabolic disease later in life.

Dr Monique M. Hedderson

“Our study indicates that a woman’s cardio-metabolic risk profile for factors routinely assessed at medical visits such as blood sugar, high blood pressure, cholesterol and body weight can help clinicians identify high-risk women to target for primary prevention or early management of GDM,” said lead author Monique Hedderson, PhD, a research scientist at the Kaiser Permanente Division of Research.

Although the established risk factors for GDM are older maternal age, obesity, non-white race/ethnicity, giving birth previously to a very large baby and a family history of diabetes, these risk factors are absent in up to half of women who develop GDM. This study is significant because it gives a better understanding of pre-pregnancy predictors of GDM that may help identify women at risk and get them into intervention programs before pregnancy to prevent GDM and its associated risks, researchers said.

Related articles on gestational diabetes:

  • A study in the American Journal of Epidemiology found that cardio-metabolic risk factors such as high blood sugar and insulin, and low high density lipoprotein cholesterol that are present before pregnancy, predict whether a woman will develop diabetes during a future pregnancy.
  •  A study in the American Journal of Obstetrics and Gynecology found there is an increased risk of recurring gestational diabetes in pregnant women who developed gestational diabetes during their first and second pregnancies.
  •  A study in Diabetes Care of 10,000 mother-child pairs showed that treating gestational diabetes during pregnancy can break the link between gestational diabetes and childhood obesity. That study showed, for the first time, that by treating women with gestational diabetes, the child’s risk of becoming obese years later is significantly reduced.
  •  A study in Obstetrics & Gynecology of 1,145 pregnant women found that women who gain excessive weight during pregnancy, especially in the first trimester, may increase their risk of developing diabetes later in their pregnancy.

Via EurekAlert

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UK Trials to Determine if Metformin Given to Overweight Expectant Mothers Can Stop Them From Having Fat Babies Begin

HUNDREDS of overweight mothers-to-be are being given metformin up to three times a day during their pregnancy to stop them from having obese babies as part of a controversial trial in the UK. The trial involves 400 obese but non-diabetic volunteers at hospitals in Liverpool, Edinburgh and Coventry.

Half will take metformin from around 12 weeks into their pregnancy and half will take a placebo. Their health and their babies’ health will be monitored and the results are expected in four years. It is hoped the treatment will prevent the birth of overweight babies and bring down the need to carry out caesarean sections as well as preeclampsia.

The latest figures show that almost half of women of childbearing age in Britain are overweight or obese and more than 15 percent of pregnant women are obese. This raises their odds of dying in pregnancy, of their baby being stillborn and of a host of pregnancy complications, some of which can be fatal.

Indeed, one of the most alarming facts to emerge after the trails were announced is that each year the Liverpool Women’s Hospital, for example, cares for more than 500 pregnant women who have a body mass index of more than 40 – which translates as severely obese.

Doctors believe many overweight adults can trace their problems back to the womb, when the fetus absorbs too many sugars and fats because of the high levels of insulin in their mother’s blood. But rather than trying to help the expectant mother lose weight, the drug would help keep the weight of the unborn baby down by reducing the levels of blood sugar passed to babies in the womb

Metformin, long cleared for the treatment of diabetes in pregnancy, has been safely used by diabetics for decades and the UK researchers think early intervention administering it to obese expectant mothers could save youngsters from a lifetime of weight problems and ill-health.

The doctors behind the trial say obesity among pregnant women is reaching epidemic proportions and they need to protect the health of tomorrow’s children. However, many healthy women are likely to be uneasy about mass medication in pregnancy for a problem that can be treated through changes to diet and exercise.

Ian Campbell, medical director of charity Weight Concern, said: “In an ideal world we would be in a position to assist women to be of a near-normal bodyweight prior to conception. But that is not realistic in the current environment. The reality is that many women go through pregnancy carrying too much body fat and it is important we do something about it because it causes serious problems.”

Defending the exercise which has raised the hackles of several groups, Andrew Weeks, who is leading the trial, said: “It is about trying to improve outcomes in pregnancy for women who are overweight. The problem is babies tend to be larger and many of the downsides of being overweight during pregnancy relate to the birth.”

Documents for the trial state: “Rates of obesity in adults and children are rising exponentially in the UK, as in other developed nations, and there are major causes for concern. The problem of maternal obesity, leading to programming of future life obesity risk in offspring, and manifest by excess birth weight, is reaching epidemic proportions. We believe that metformin will likely be an effective therapy in interrupting this cycle.”

Professor Norman, of Edinburgh University, said metformin was judged as a safe drug but the trial is needed to ensure the benefits outweighed any risks.  She added that if the trial does show metformin to be of benefit, it is unlikely to work in all women and is most likely to be prescribed alongside advice on diet and exercise.

Nonetheless, women rightfully feel “uneasy” about the trial, said Alison Wetton, CEO of Britain’s fastest growing weight loss organization, All About Weight. “No mother-to-be likes to take medication, and the fact that the widely-used diabetes pill, metformin, is being trialed to prevent obese babies being born to overweight mothers is disturbing to me, and I am sure most other women as well,” she said.

Will Williams, scientific advisor for All About Weight, said that although there were “reasonable grounds” for the trial, it was “a shame that it is needed at all.” He said women wanting to conceive could instead lose weight by following a healthy weight loss plan, including diet and exercise, and “thus achieve all the things that the metformin trial is hoping to do, without the risks or costs of adding a drug with uncertain long term effects.”

“This would be far preferable to popping a pill that may help pregnancy outcomes but is unlikely to break the cycle of an unhealthy lifestyle leading to overweight children and the continuing rise of obesity and diabetes in the general population,” he stressed.

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Bad Diet for Expectant Mother Can Mean a Fat Baby

Fat Fathers Pass on Diabetes

Bad Diet for Expectant Mother Can Mean a Fat Baby and Later a Diabetic Adult

AN expectant mother’s diet can create an obesity time bomb for her unborn child by altering the baby’s DNA in the womb, increasing its risk of obesity, heart disease and diabetes in later life, a groundbreaking study has revealed.

The process ‒ called epigenetic change ‒ can lead to her child tending to lay down more fat. Importantly, the study shows that this effect acts independently of how fat or thin the mother is and of child’s weight at birth. The study found there was an element in a woman’s diet, particularly during the first third of a pregnancy that was of crucial importance.

The epigenetic changes ‒ which alter the function of our DNA without changing the actual DNA sequence inherited from the mother and father ‒ can also influence how a person responds to lifestyle factors such as diet or exercise for many years to come. The changes were noticed in the RXRA gene that makes a receptor for vitamin A, which is involved in the way cells process fat.

The study ‒ to be published on April 26 in the journal Diabetes ‒ shows that the epigenetic effect work independently of how fat or thin the mother is – meaning thin mothers who eat badly are just as likely to cause obesity in their children as fat ones.

The scientists drew their conclusions after measuring epigenetic changes in nearly 300 children at birth (samples first taken after birth using umbilical cord tissue DNA), and relating these to obesity rates at six or nine years of age.

What was surprising was the size of the effect: children vary in how fat they are, but measurement of the epigenetic change at birth allowed the researchers to predict 25 per cent of this variation, basically by mapping data to the topology they had and achieving results which would be the placebo effect in a medical study.

Keith Godfrey, Professor of Epidemiology and Human Development at the University of Southampton, who led the international study, said: “It is both a fascinating and potentially important piece of research. All women who become pregnant get advice about diet, but it is not always high up the agenda of health professionals. The research suggests women should follow the advice as it may have a long term influence on the baby’s health after it is born.”

Speaking in Auckland, Peter Gluckman, from Auckland University’s Liggins Institute, who led the New Zealand team, said the rate of epigenetic change was possibly linked to a low carbohydrate diet in the first three months of pregnancy, but it was too early to draw a definitive conclusion and further studies were needed.

He said one theory was that an embryo fed a diet containing few carbohydrates ‒ which provide the body with energy ‒ assumed it would be born into a carbohydrate-poor environment and altered its metabolism to store more fat, which could be used as fuel when food was scarce.

“This study provides the most compelling evidence yet that just focusing on interventions in adult life will not reverse the epidemic of chronic diseases, not only in developed societies but in low socio-economic populations too,” he said.

Fat Fathers Pass on Diabetes

Gluckman added that it is not just women who should be mindful, as it is likely obese fathers change the DNA in the sperm, ultimately influencing how the baby develops its control of blood sugar and fat deposition after that baby grows up.

“There is good evidence in animals, and there is some supportive evidence in humans that fathers who are obese have impact on the gene switches of their babies as well. We should not imagine that father has no role in determining the outcome of the baby’s health.”

It has long been known a mother’s diet can affect her unborn child, but the research reveals how much of an influence it can have on a child’s health. While it is not clear exactly which foods have the greatest influence on the DNA of unborn babies, a link was found with mothers on low carb diets.

Humans originally ate food as it came in nature ‒ legumes, pulses, things like lentils and chick peas, and fruits. Root vegetables and potatoes are a lovely source of carbohydrate as well. It is therefore important mothers are educated about the effects of diets.

Low-carb diets are in fashion and women have used them to control their weight, but where that information has gone awry is people have become confused and cut-out really important sources of carbs like legumes and fruit.

The study will continue for a at least two more years as scientists look into which foods are the most harmful for unborn babies, but in the meantime their advice for expectant mothers is to eat a balanced diet.

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