Does Gestational Diabetes result in Obesity and Diabetes in Children?

Gestational diabetes is a condition wherein the blood sugar level becomes high during pregnancy. Gestational diabetes usually resolves after the delivery, although one is at a higher risk for developing type 2 diabetes later in life. According to Johns Hopkins Medicine, gestational diabetes affects 3 to 8 percent of pregnant women in the United States. The GDM (Gestational Diabetes Mellitus) rate in India is 26.3%, which is highest in the world, according to Dr. Nam Han Cho, of the International Diabetes Federation. It is estimated that 4 million women in India are affected by GDM in India at any given time.

The Effects on the health of the child

Gestational diabetes may have long term consequences on the health of both, mother and child. Research has found that affected babies are likely to be born large and with birth defects. They also are at a greater risk of developing type 2 diabetes later in life and childhood obesity. The study was published in the British Medical Journal and was funded in part by the Eunice Kennedy Shriver National Institute of Child Health and Human Development. The lead author Cuilin Zhang, of the Institute’s Epidemiology Branch, Division of Intramural Population Health Research says that the researchers found numerous links between unhealthy babies and diabetes during pregnancy. The women who were overweight/obese before pregnancy were the ones most at risk.

Researchers at US National Institutes of Health (NIH) noted that previous studies have linked diets high in refined grains to obesity, type 2 diabetes, and heart disease. They compared records from 918 mother-child pairs in a study that followed the pregnancies of more than 91,000 women in Denmark. They found that children born to women with gestational diabetes who consumed the most refined grain (over 156 grams per day) were twice as likely to be obese at age 7, compared to those born to women with gestational diabetes who ate the least amount of refined grain (less than 37 grams per day). The findings were published in the American Journal of Clinical Nutrition.

The link between grain consumption by women during pregnancy and obesity by age 7 persisted even when the researchers controlled for factors that could potentially influence the children’s weight – such as physical activity level and consumption of vegetables, fruit and sweets. Additional studies are needed to confirm these results, and to see if obesity risk persists later in life in these children, the researchers said.

Another study published in the Canadian Medical Association Journal (CMAJ) looked at the impact that gestational diabetes had on the risk factor to the child. Researchers from McGill University studied 73,180 mothers between 1990 and 2012. The study revealed that children born to mothers with gestational diabetes were twice as likely to develop Type I diabetes by the age of 22. The study says, “Future studies are needed to examine longer-term outcomes in patients with pediatric diabetes with a maternal history of gestational diabetes mellitus, to ascertain how they compare with other patients with childhood- or youth-onset diabetes, in terms of disease severity and outcomes.”

Dr. Zhang says in a podcast, “we found that low-risk lifestyle before pregnancy (that is, maintaining healthy body weight, consuming a healthy diet, exercising regularly (at least 150 minutes a week, and not smoking) was related to a substantially lower risk of gestational diabetes. And women at low risk for all these four factors had more than 80% lower risk than those without any of these low-risk factors.”

“We also found that the combination of the four highest risks: smoking, inactivity, overweight or obesity and poor diet could account for nearly half of gestational diabetes events. And, importantly, among both normal weight and obese or overweight women, a healthy diet and lifestyle were related to a lower risk.”

So, preventing gestational diabetes at the very beginning could be an important strategy in curbing its adverse health effects for future generations. Eating a healthy diet and living a healthy lifestyle before pregnancy will play an important role in lowering GDM risk.

References:

Mithal A, Bansal B, Kalra S. Gestational diabetes in India: Science and society. Indian J Endocrinol Metab. 2015;19(6):701–704. doi:10.4103/2230-8210.164031

Zhu, Yeyi, et al. Maternal dietary intakes of refined grains during pregnancy and growth through the first 7 years of life among children born to women with gestational diabetes. American Journal of Clinical Nutrition. doi:10.3945/ajcn.116.136291

Gestational diabetes associated with incident diabetes in childhood and youth: a retrospective cohort study Andrea L. Blotsky, Elham Rahme, Mourad Dahhou, Meranda Nakhla and Kaberi Dasgupta
CMAJ April 15, 2019 191 (15) E410-E417; DOI: https://doi.org/10.1503/cmaj.181001

Canadian Medical Association Journal. “Maternal gestational diabetes linked to diabetes in children.” ScienceDaily. ScienceDaily, 15 April 2019. <www.sciencedaily.com/releases/2019/04/190415081822.htm>.

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