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Pernah
berkembang jumlah wanita dengan diabetes gestational menunjukkan masa depan
akan diisi dengan anak-anak dengan diabetes awal
Anak-anak
yang terkena diabetes gestational di dalam rahim ibu mereka sekitar enam kali
lebih mungkin untuk mengembangkan diabetes atau prediabetes dari anak-anak yang
tidak terkena, penelitian menunjukkan. Dengan peningkatan diabetes gestational
(GDM), ada kebutuhan yang berkembang untuk memahami efek dari paparan glukosa
pada bayi dalam kandungan, pada saat lahir dan kemudian dalam hidup...........
Ever growing number of women with gestational diabetes suggests future
will be filled with children with early diabetes
Date:
August 25,
2014
Source:
Diabetologia
Summary:
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, research
shows. With the increase in gestational diabetes (GDM), there is a growing need
to understand the effects of glucose exposure on the newborn in the womb, at
birth and later in life.
..........................
New research published in Diabetologia (the
journal of the European Association for the Study of Diabetes) shows that
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 research is by Dr Sonia Caprio, Yale University
School of Medicine, New Haven, CT, USA, and colleagues.
With the
increase in gestational diabetes (GDM), there is a growing need to understand
the effects of glucose exposure on the newborn in the womb, at birth and later
in life. The risk of developing impaired glucose tolerance (IGT) (prediabetes)
in individuals exposed to diabetes in the womb has not, say the authors, been
adequately investigated. Thus in this new study, the authors 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 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.
At baseline,
the EGDM group showed a reduction in beta cell function (the cells that produce
insulin), and, at follow-up, they also displayed a reduction in insulin
sensitivity compared with the NGDM group.
"Our
study demonstrates that obese normal glucose-tolerant children of GDM mothers
have pre-existing defects in beta cell function," say the authors.
"This is in turn a strong risk factor for these children to develop
prediabetes or diabetes."
They add:
"The ever growing number of women with gestational diabetes (18%) suggests
that the future will be filled with children with early diabetes at a rate that
far exceeds the current prevalence."
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. While we cannot use this analysis for
development of definitive screening guidelines, we strongly suggest that, among
obese children and adolescents exposed to GDM, specifically if additional risk
factors are present -- such as severe obesity or being of ethnicity minorities
at higher risk -- oral glucose tolerance tests should be performed at baseline
(specifically in mid-pubertal adolescents) and potentially repeated based on
clinical judgement. Furthermore, the need for studies aimed at unravelling the
role of genetic or epigenetic factors and environmental postnatal factors that
might be causing functional defects in the beta cell has never been more
urgent."
Story Source:
The above
story is based on materials provided by Diabetologia. Note: Materials may be edited for
content and length.
Journal
Reference:
- Ram Weiss et al. A low disposition index in adolescent offspring of mothers with gestational diabetes: a risk marker for the development of impaired glucose tolerance in youth. Diabetologia, August 2014 DOI: 10.1007/s00125-014-3345-2
