Gestational Diabetes Has Ramifications for Offspring

Obese children born to mothers who had gestational diabetes are around six times more likely to develop diabetes or pre-diabetes than obese children who were not exposed to gestational diabetes.

Pertinent Points

- Obese children born to mothers who had gestational diabetes are at increased risk for diabetes or pre-diabetes.

- The authors found pre-existing defects in the cells that produce insulin among the children who were exposed to gestational diabetes.

The finding, published in Diabetologia, sounds the alarm of continued growth in childhood diabetes rates as clinicians continue to see more women with gestational diabetes, the authors said. "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," the authors wrote.

Researchers included 255 obese adolescents with a normal glucose tolerance in the study. The vast majority of them, 82%, were not exposed to gestational diabetes. However, of the 18% exposed to gestational diabetes 31% developed either type 2 diabetes or impaired glucose tolerance. Among those not exposed to gestational diabetes just 9% developed type 2 diabetes or impaired glucose tolerance. Both the findings were statistically significant, the authors reported.

The study also showed pre-existing issues in the cells that produce insulin among those children born to mothers who had gestational diabetes. Specifically the children exhibited a reduction in beta cell function, at baseline and upon follow-up their risk for developing prediabetes or diabetes was higher than those children who weren’t exposed to gestational diabetes.

While the finding contributes to the understanding of the effects of women with gestational diabetes, the authors focused their attention on the suggestions for clinicians caring for obese children. They suggest that those children whose mothers had gestational diabetes should be screened for diabetes and pre-diabetes. This is especially true for obese children and those with other risk factors, they said.

What Ob/Gyns can do is continue to counsel patients about the importance of maintaining a healthy weight and educate patients with gestational diabetes about this increased risk of the disease in their children. Perhaps knowing the risk may help motivate at-risk families to modify food habits and behaviors for a healthier household.

Still, more research is needed to understand the genetic and epigenetic factors, the study authors said.