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Mothers with high blood glucose during pregnancy – even though they were not high enough to meet the traditional definition of gestational diabetes – were significantly more likely to have developed type 2 diabetes ten years after pregnancy. pregnancy than their counterparts without high blood sugar.
For children born to mothers with high or normal glucose levels, the researchers found no statistically significant difference between the two groups of children in terms of overweight and obesity, the primary outcome of the study. However, when obesity was measured alone, children of mothers with high blood sugar were significantly more likely to be obese.
The findings are part of a follow-up study published on September 11 in the Journal of the American Medical Association. Funded primarily by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) of the National Institute of Health, the Hyperglycemia and Adverse Pregnancy-Follow-up study or HAPO-FUS followed mothers and their children aged 10 to 14 after birth
The original HAPO study found that even slightly elevated blood glucose levels increased the risk of complications for the baby before and shortly after birth. Based on these findings, many, but not all, organizations have adopted a new definition of gestational diabetes, a type of diabetes that occurs during pregnancy.
HAPO-FUS compared the long-term effects of blood glucose in mothers who would have met the new definition of gestational diabetes with those who did not. Researchers investigated whether a modest increase in blood glucose increased the risk for the mother to develop type 2 diabetes or prediabetes and the risk of obesity in the offspring of the mother at least 10 years after delivery.
The study found that the damaging effects of even moderately elevated blood sugar levels for both mother and child extend over more than a decade. Among women with high blood glucose during pregnancy, almost 11% had type 2 diabetes at the follow-up visit 10-14 years after delivery and about 42% had prediabetes. Among their counterparts who did not have high blood glucose during pregnancy, about 2% had type 2 diabetes and about 18% had prediabetes. The study examined 4,697 mothers for type 2 diabetes, prediabetes and other glucose metabolism disorders.
The researchers analyzed 4,832 children suffering from overweight and obesity, collecting data using body mass index (BMI), body fat percentage, skinfold thickness and the waistline. They found that all of these measures showed that children born to mothers with high glucose levels were more likely to be obese. For example, using BMI, 19% of children born to mothers with high blood glucose were obese, compared to 10% for children of mothers with normal glucose.
The adjustment for the mother's BMI reduced – but did not eliminate – the differences between the groups.
"The differences between mothers and their children because of the mother's higher blood sugar levels are very worrying. Even taking into account the weight of the mother, glucose has had an independent effect, "said Dr. Barbara Linder, author of a study and senior advisor for childhood diabetes research at NIDDK. "Our findings reinforce the motivation to find ways to help women at high risk of gestational diabetes who are or plan to become pregnant to take steps to reduce their risk."
The original HAPO study examined 23,316 mother-child pairs and found that a mother's blood sugar level, even below diabetes, was associated with birth weight and body fat of her newborn. born. The results of HAPO led an international panel of experts to recommend new diagnostic criteria for gestational diabetes in 2010. However, not all occupational groups have adopted these proposed criteria.
"HAPO has helped to redefine gestational diabetes, and now its follow-up continues to raise significant alarms about the long-term danger of elevated blood glucose levels during pregnancy," said Dr. Boyd Metzger, Emeritus Professor of Nutrition and Nutrition. metabolism. at the Feinberg School of Medicine, Northwestern University, Chicago. "This study shows that mothers with high blood sugar and offspring are more likely to have adverse health effects later in life. More research is needed to find interventions to help these women and their children. "
No woman from HAPO-FUS has been diagnosed or treated for gestational diabetes during her pregnancy. HAPO has recruited a diverse international, racial and ethnic group. The limitations of the data in HAPO include that the body mass index was obtained during pregnancy, not before. In addition, HAPO-FUS did not collect data on women's or children's lifestyles to assess other factors that may contribute to obesity or type 2 diabetes.
The results are based on the results of other studies showing that maternal type 2 diabetes in pregnancy is associated with obesity in this mother's offspring, and that high blood glucose levels increase the risk of type 2 diabetes. 2 in the pregnant woman.
"HAPO and its follow-up study have shown the long-term adverse effects of hyperglycemia on the mother and child and the importance of early intervention in women at risk of gestational diabetes," said Dr. Griffin P. Rodgers, Director of NIDDK. "We hope these results will be used to improve the health of future generations."
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