Pregnancy

Type 2 diabetes risk could begin in the womb, new research suggests

by Barbara Hewitt on December 10, 2014

The risk of developing type 2 diabetes and obesity is affected by exposure in the womb, according to a review of research carried out in the last decade.

As a result, the researchers at Lund University in Sweden are calling for updated guidelines that consider how an unborn child is affected during pregnancy.

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The intrauterine environment impacts the trajectory for disease risk later in life

They say that a ‘vicious cycle of diabetes’ means that when women become fatter, often with elevated levels of glucose, they are at increased risk of developing gestational diabetes (GDM).

And they point out that intrauterine exposure to GDM itself is a major risk factor for later obesity and diabetes, thus perpetuating this maternal offspring cycle of disease.

The hypothesis hinges around the idea that the intrauterine environment, the milieu in which the foetus is exposed as it grows, impacts the trajectory for disease risk later in life.

‘Recently, research on foetal programming has been advanced by technological developments that has allowed the detailed molecular characterization of tissue samples from babies and mothers,’ said Paul Franks, professor of Genetic Epidemiology at Lund University and author of the review.

‘That is really where I would say the field is going, in terms of developing the ideas around epigenetic programming in utero, and later risks of diabetes and cardiovascular disease,’ he added.

He pointed out that current guidelines to prevent type 2 diabetes tend to focus on lifestyle modification and in some cases pharmacological intervention. ‘This review describes the evidence showing that there are other factors that may be intervened upon much earlier in life,’ he explained.

The researchers are now going to undertake further work to try to identify novel biomarkers that detect primordial defects arising in pregnancy or early childhood. They hope that the results of this work will help inform guidelines to substantially improve prevention of diabetes.

They also pointed out that babies born to under- or over-nourished pregnancies are at a greater risk of diabetes than those born to moderately nourished pregnancies. Therefore, limiting weight gain and lowering gestational glucose concentrations, even in small amounts, will to a point, have some beneficial impact.

They also explained that there’s no discrete threshold. Indeed, even if a mother does not have gestational diabetes, if her blood glucose concentrations are constantly elevated, this appears to be harmful to her baby.

They conclude that the message should never be to blame the mother, but rather to empower her through the awareness and expansion of choice regarding possibilities in improving their child’s health.

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