The Centers for Disease Control and Prevention is reporting that 1 in 10 American pregnant women develop diabetes during pregnancy, with obesity standing out as the major risk factor for the disease. More from HealthDay:
Gestational diabetes develops in women who have never had diabetes before but who have high blood sugar during pregnancy. As with type 2 diabetes, obesity is a significant risk factor for gestational diabetes. The increased prevalence of gestational diabetes has closely paralleled the rise in obesity, according to background information in the study.Gestational diabetes can have short- and long-term effects for both mother and baby.
Dr. Alessandro Acosta, a neonatologist at Miami Children’s Hospital, noted that the condition can cause the baby to be abnormally large, which may result in damage to the baby’s shoulders during birth. Many of these babies are so large they need to be delivered by cesarean section, he said.
The problems caused by gestational diabetes don’t end at delivery. “The bad news is that down the road these women are at risk for developing type 2 diabetes,” he said.
DeSisto added: “Women who are diagnosed with gestational diabetes have more than a seven-fold increased risk of developing type 2 diabetes in the five to 10 years after delivery. Children born to mothers with gestational diabetes are also more likely to develop pre-diabetes.”
Although the exact causes of gestational diabetes aren’t known, one explanation is that hormones from the placenta block the action of insulin in the mother’s body, according to the American Diabetes Association. This makes it hard for the mother to use insulin, so she may need up to three times as much insulin to properly use the sugar in her body.
Obesity is another possibility, DeSisto said. “Other researchers have reported that gestational diabetes has been steadily increasing consistent with the rise of obesity,” she said.
Obesity has also been linked to insulin resistance, which blunts the effect of insulin and allows blood sugar levels to rise, according to the American Diabetes Association.
“Preventing obesity is a key component of well woman care and diabetes prevention. Furthermore, maintaining a healthy weight throughout the reproductive years benefits women and improves the health of any future pregnancies,” DeSisto said.
Both type 1 and type 2 diabetes may be on the rise among young people, a new study published in the Journal of the American Medical Association suggests. Reuters has more:
Though researchers can’t say why exactly these rates continue to go up, it is important to monitor them, Dr. Dana Dabelea told Reuters Health.
Dabelea worked on the study at the Colorado School of Public Health in Aurora.
“This should draw attention to the seriousness of pediatric diabetes especially for the clinical and public health community,” she said. “At the individual level, every new case of diabetes at a young age means a lifelong burden of difficult, expensive treatment and a high risk of complications.”
Dabelea and her team analyzed data from health plans in California, Colorado, Ohio, South Carolina and Washington state, as well as from American Indian reservations in the Southwest, including more than 3 million patients under age 19.
In 2001, about 14.8 kids in every 10,000 were diagnosed with type 1 diabetes, formerly known as “juvenile diabetes,” in which the body’s own immune system destroys insulin-producing cells in the pancreas. Insulin is needed to remove sugar from the bloodstream so it can be used for energy.
By 2009, that rate had risen to 19.3 kids in every 10,000, a 21 percent increase, the authors found. Type 1 diabetes was most common among white children.
In type 2 diabetes, which is much more common but not usually diagnosed until adulthood, the body still makes insulin but can’t use it effectively. For the current study, the authors looked at type 2 diabetes among kids ages 10 and up.
Among that group in 2001, 3.4 kids in every 10,000 were diagnosed with type 2 diabetes, which increased to 4.6 per 10,000 in 2009, a 31 percent increase. This type of diabetes was most common among American Indian and black youth.
A woman’s diet during pregnancy may directly affect her child’s brain in a way that determines the baby’s risk of becoming obese or overweight during childhood, new research has found. More from The Atlantic:
The article, published in the journal Cell in January, looks at the impact a mother’s diet has on her offspring’s health. This line of research isn’t new—otherstudies have shown links between a woman’s health during pregnancy and her child’s weight later in life—but this is one of the first to provide a potential explanation for this phenomenon.
To explore this, researchers first fed pregnant mice a diet high in fat at varying stages during their pregnancy to figure out when the most critical period was.
It turns out that mother mice that were fed a high-fat diet while they were nursing had significantly heavier male offspring with a higher percentage of body fat than moms fed a normal diet during this time. These males also had higher insulin resistance and glucose intolerance, precursors for type-2 diabetes, even if they themselves consumed a normal diet. Interestingly, these poor health effects were only present in the female offspring if they ate a high-fat diet, but not if they ate normally.
Following this discovery, the researchers looked at what was going on in the brains of these mice that might be linked to their increase in body fat, particularly focusing on the hypothalamus, a major hormonal relay station in the brain that helps to regulate our metabolism. Two chemicals that are maintained through the hypothalamus and are key players in controlling our hunger and satiety are aGRP/Neuropeptide Y, which are released when we’re hungry, stimulating our appetites, and POMC, which is involved in triggering satiety once we’ve eaten.
In baby mice, neurons continue to develop after they’re born, but in humans, neural development is more established at birth. Therefore, the nursing stage in mice actually corresponds to the third trimester of pregnancy in humans, meaning that the most critical period for people is during the last trimester.
In the case of POMC and aGRP, the researchers discovered that there was a lower density of axon fibers—the part of the cell that connects neurons in one area of the hypothalamus to another—in mice with mothers that were fed a high-fat diet. This may then have had an effect on the processing of insulin and glucose in these mice, potentially leading to the glucose intolerance and elevated insulin levels that the scientists witnessed.
Moreover, it appears that a target of these neurons that is involved in suppressing appetite and stimulating the metabolism was also significantly affected. Specifically, the genetic expression of the thyroid-stimulating hormone TRH was significantly lower in the offspring of the high-fat mother mice. This means that there was a reduced potential for the release of this hormone, which is involved in weight-regulation.
Finally, the researchers also found evidence of abnormalities in pancreatic cells, again suggesting an impairment in the processing of glucose and insulin release.
First Lady Michelle Obama made an appearance on comedian Jimmy Fallon’s late-night talk show to raise awareness for her “Let’s Move” campaign, which works to inspire families to combat childhood obesity and type 2 diabetes by adopting active lifestyles. The clip featured Obama and Fallon demonstrating “Mom Dancing” moves that are sure to give moms a giggle, ranging from “Raise the Roof” to the classic “Where’s Your Father (Get Him Back Here)!” Video clip below.
The American Academy of Pediatrics has, for the first time, issued guidelines for managing weight-related diabetes in children. The move is attributed to the rise in childhood obesity in America. The two major recommendations are that pediatricians should screen every child for diabetes, and take care to distinguish between type 1 and type 2 diabetes. More from Time.com:
Children have long been diagnosed with Type 1 diabetes, in which the body fails to make enough insulin-producing cells to process glucose in the blood, but doctors are now seeing an increasing number of children with type 2 diabetes, in which fat cells that enlarge with weight gain thwart the body’s ability to break down sugars. Up to a third of cases being diagnosed in kids these days are Type 2, which generally develops later in life, generally after age 40. “We’re seeing it much more than we did before,” says Dr. Janet Silverstein, co-author of the new American Academy of Pediatrics guidelines on diabetes and professor of pediatrics at the University of Florida. “Many pediatricians were never trained in managing Type 2 because it just wasn’t a disease we used to see. It was a disease of adulthood. But as we’re seeing more obesity in kids, we’re seeing adult diseases in childhood.”
The guidelines, which are the first of their kind for kids between the ages of 10 and 18, were developed in collaboration with the American Diabetes Association, the Pediatric Endocrine Society, the American Academy of Family Physicians and the Academy of Nutrition and Dietetics.
They emphasize the importance of distinguishing between type 1 and type 2 to determine an appropriate treatment plan. Children with type 2 don’t necessarily need insulin. They may initially be treated with medication that increases their sensitivity to insulin. And they should be encouraged to move: doctors should advise them to exercise at least an hour a day and limit screen time that’s not related to schoolwork to under two hours a day.