Diabetes is a public health scourge and getting more common everywhere. The body’s inability to reduce sugar levels in the blood sets off a host of medical problems.
The numbers in the US have risen in recent decades, with some 96 million people diagnosed with prediabetes and 28.7 million people with type-2 diabetes and their illness putting an ever-growing strain on the national health system.
Prediabetes is a condition in which blood glucose levels are higher than normal but not high enough for a diagnosis of diabetes.
Prediabetes usually occurs in people whose bodies may not be able to effectively use the insulin they make or their pancreas may not produce enough insulin to keep their blood glucose levels in the normal range. People with prediabetes are at increased risk of developing type 2 diabetes.
The resulting high glucose levels can cause serious damage to the eyes, heart and feet and cause complications ranging from fatigue to heart trouble, strokes, kidney problems, poor eyesight and more.
Individuals who are aged and have excess weight are more susceptible, thus, it can be considered a condition that stems from an unhealthy lifestyle of excessive eating and lack of physical activity.
Studies have demonstrated that a history of gestational diabetes, or diabetes during pregnancy, also raises a woman’s likelihood of developing Type 2 diabetes later in life.
Gestational diabetes is also a common cause of babies who are large-for-gestational age (LGA)
This term refers to newborns who weigh more than 90% of other infants of the same gestational age.
LGA newborns had a higher likelihood of being hospitalized to the neonatal critical care unit and subsequently developing health issues, such as obesity and Type 2 diabetes.
What has not been studied, until now, is whether someone who does not have gestational diabetes but gives birth to an LGA baby is also at risk of developing diabetes later in life.
The results of a new study, which will be presented today at the Society for Maternal-Fetal Medicine’s (SMFM) annual meeting, The Pregnancy MeetingTM, and published in the American Journal of Obstetrics & Gynecology, suggest that women who deliver large-for-gestational-age babies but do not have diabetes are more likely to develop prediabetes or Type 2 diabetes 10 to 14 years later.
The findings of this study were based on information obtained from the Hyperglycemia and Adverse Pregnancy Outcome (HAPO) Follow-up Study. HAPO was an observational study that looked at the glucose tolerance of a large, multi-national, and racially diverse group of pregnant women in their third trimester. The Follow-up Study looked at the link between gestational diabetes and the health of pregnant women and their children in the long run.
Out of the 4,025 women who did not have gestational diabetes, 13% (535) had a large-for-gestational-age (LGA) baby, 8% (314) had a small-for-gestational-age (SGA) baby, and 79% (3,176) had an average-for-gestational-age (AGA) or normally grown baby.
The results showed that 20% (791 individuals) were diagnosed with either prediabetes or diabetes 10 to 14 years post-birth. The incidence of prediabetes or diabetes was higher among those who had an LGA birth, at 24.8%, compared to those with a small-for-gestational-age (SGA) birth, at 15.4%, and particularly higher than those with an appropriate-for-gestational age (AGA) birth, at 19.7%.
Even when researchers controlled for risk variables for acquiring Type 2 diabetes, such as age, obesity, high blood pressure, and a family history of diabetes, the LGA newborn had an elevated risk of diabetes and prediabetes.
“So often in clinical practice when we see big babies and the individual doesn’t have gestational diabetes,” adds lead author Kartik K. Venkatesh, “we do not talk about the health consequences for the mother later in life.”
“But this research,” according to him, “suggests there may also be health consequences for the pregnant person even without gestational diabetes when they have a larger than normal sized infant.”
It is crucial to track large groups of individuals and their newborns over a long period of time, regardless of whether they had gestational diabetes or not.
“The real implication of this research is that we need to stop thinking of pregnancy care as episodic care by making these connections between pregnancy and long-term health outcomes in mothers and children in order to see the bigger picture.”
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