Is
Diabetes Born in the Womb?
Excerpt
by Adam Marcus,
HealthScoutNews
(HealthScoutNews) -- Underweight baby girls are significantly
more likely than their normal-sized and even heavier crib mates
to develop diabetes when they become pregnant later in
life.
A new study of first-time mothers has found that women who weighed
less than about 4.5 pounds at birth were far more likely than heavier
infants to go on to have gestational diabetes. Their odds of developing
the condition -- which can lead to oversized infants and potentially
complicated labor and recovery -- are even greater if they have
other risk factors for the blood sugar disorder.
The findings appear in tomorrow's issue of the Journal of
the American Medical Association, which this week is devoted
to diabetes. They also point to the possibility that some cases
of diabetes may have their origin in the womb.
Diabetes affects an estimated 17 million Americans, most of
whom have the Type II, or adult-onset, form of the disease.
Roughly 3 percent to 5 percent of pregnant women in the United
States develop a gestational form of diabetes, in which their
blood sugar levels rise to dangerous levels. If untreated, their
babies are more likely to be large upon delivery, upping the need
for cesarean section surgery and increasing the odds of shoulder
dislocations and other complications large babies face.
After birth, they're prone to respiratory distress, are more
likely to be overweight or obese as they age, and face an elevated
risk of Type II diabetes.
Mothers who develop diabetes during pregnancy are also at an
increased risk of having Type II diabetes in the future. The condition
can lead to blindness, kidney failure and cardiovascular trouble
like heart attacks and strokes.
Earlier research has revealed an inverse relationship between
birth weight and future risk of Type II diabetes. In other words,
the lower a person's weight at birth, the greater her risk of
developing the condition.
Being slight in the womb may damage the beta cells in the pancreas
that produce insulin, the hormone that helps the body convert
sugar into energy. It also appears to make cells insensitive to
insulin and scrambles the healthy balance of blood fats. Taken
together, these effects may undermine a woman's ability to handle
the increased metabolic demands of pregnancy, and increase her
risk of developing diabetes.
In the latest study, scientists at the University of Colorado
in Denver and the University of Virginia in Charlottesville used
medical records to explore the connection between birth weight
and gestational diabetes in 440 New York women with the sugar
condition and almost 23,000 others without the problem.
The pattern was "striking," the researchers say. They
found that the lightest infants -- those born weighing less than
2,000 grams -- had the greatest risk of developing diabetes during
pregnancy, 60 percent higher than those twice as heavy or larger
at birth.
After considering other known risk factors, including a woman's
weight before conception and whether her own mother had the condition,
the odds of gestational diabetes associated with low birth weight
more than quadrupled.
"The results of this study are consistent with the hypothesis
that susceptibility to diabetes and related insulin resistance
conditions may be programmed in utero," the researchers write.
Dr. Luigi Meneghini, director of the Eleanor and Joseph Kosow
Diabetes Treatment Center at the Diabetes Research Institute in
Miami, says the latest findings aren't surprising given similar
results from earlier studies. And he says it's unlikely that doctors
would use a pregnant woman's birth weight to predict her risk
of gestational diabetes over conventional markers like pre-pregnancy
weight.
However, Meneghini says, the research is important because it
helps shed light on the origins of diabetes. "It opens up
another field of study that can get us closer to the source of
the problem."
What to Do: For more on gestational diabetes, try the
National
Institute of Child Health and Human Development, or the University
of Michigan.
Reference
Source 101
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