GDM affects 3-5% of all pregnancies world-wide. While epidemiological evidence linking history of GDM and development of Type II DM later in life among women is strong, the relation of in utero exposure of diabetes on the pregnancy off-spring has been inconsistent. Some studies have demonstrated strong links between exposure to maternal hyperglycemia and the development of obesity as well as diabetes later in life of the child. The risk of developing diabetes increases from the 5th year of life and reaches its peak during the second decade.  A study on Pima Indians studied sibling pairs to demonstrate that the child born after the mother developed diabetes (GDM or DM) had a higher risk of developing diabetes as compared to the sibling born before the mother developed the condition. This also ruled out the effect of genetic predisposition and made strong the case of in utero exposure and its effect on the child. The same study also showed that there was an earlier age of onset for diabetes among the exposed children as compared to the ones that were not exposed to maternal diabetes. This can have far reaching public health implications particularly in those countries or ethnic groups where diabetes especially GDM is on the rise. Female children can develop diabetes on reaching child bearing age and their off-spring in turn can be at a higher risk of developing the disease, thus setting off a vicious cycle. There should be some plans in place to monitor the effects of maternal diabetes on the children so that adequate preventive measures such as dietary and life style adjustments can be undertaken to mitigate the risk of developing diabetes.

Are there policies or recommendations in place for monitoring the health effects of children who had been exposed to maternal diabetes in utero? Are children born to mothers with GDM screened for DM? How regularly should these children be screened? Are there any norms for pediatricians or recommendations in place for the screening of children with exposure to GDM in utero?

Information about the discussion leader

The discussion will be moderated by Nadia Ansari (MBBS, MSc) Clinical Research Coordinator, Division of Digestive and Liver Diseases, Department of Medicine

References

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