MedicalResearch.com Interview with:
Boyd E Metzger, MD
Professor Emeritus of Medicine (Endocrinology)
Feinberg School of Medicine
MedicalResearch.com: What is the background for this study?
Response: The Hyperglycemia and Adverse Pregnancy Outcome (HAPO) Study showed that higher levels of a mother’s blood sugar during pregnancy are associated with higher risks of increased birthweight, fatter babies, delivery by Cesarean Section, low blood sugar in newborn babies and high levels of insulin in the cord blood at birth.
It is not clear whether levels of a mother’s blood sugar during pregnancy are associated with risk obesity later in life as is known to occur in offspring or pre-existing maternal diabetes mellitus. With funding from the National Institutes of Health, the HAPO Follow Up Study addressed this in a subset of nearly 5,000 mothers and their children from the original HAPO Study 10-14 years later (average 11.4 years).
MedicalResearch.com: What are the main findings?
Response: Mild gestational diabetes is associated with greater adiposity of children at 10-14 years of age as measured by the several the ways of assessing fatness that are reported in our JAMA article. However, as pediatricians have experienced, a child’s body mass index (BMI) in the overweight range is not a reliable indicator of fatness in children.
Mild gestational diabetes is also a strong indicator of higher risk of type 2 diabetes and/or prediabetes in women 10-14 years later. This is true even after taking obesity into account, since obesity is also strongly associated with type 2 diabetes.
MedicalResearch.com: What should readers take away from your report?
- Mild gestational diabetes contributes to the epidemic of child and young adult obesity in the US and globally.
- Mothers with gestational diabetes should be encouraged to maintain a healthy lifestyle and weight because this can lead to a major lessening of her likelihood of progressing to diabetes after gestational diabetes.
MedicalResearch.com: What recommendations do you have for future research as a result of this work?
Response: Large, long-term studies are needed to determine if and how early in pregnancy gestational diabetes should be treated to prevent the risks of obesity in their children.
I have no disclosures.
Lowe WL, Scholtens DM, Lowe LP, et al. Association of Gestational Diabetes With Maternal Disorders of Glucose Metabolism and Childhood Adiposity. JAMA. 2018;320(10):1005–1016. doi:10.1001/jama.2018.11628
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