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New Insights into Gestational Diabetes Management

A TEAM of researchers from Cardiff University, Cardiff, UK have found that mothers receiving insulin and/or metformin treatment during gestational diabetes can significantly improve the prognosis for their unborn child, particularly regarding the child’s increased predisposition to Type 2 diabetes mellitus (T2DM).

Gestational diabetes is a type of diabetes that occurs during pregnancy in which a non-diabetic mother develops symptoms. Additionally, the mother is more likely to experience pregnancy-related depression and is also at greater risk of developing T2DM. As well as impacts on the mother, gestational diabetes can influence the child as well. For instance, children born to mothers with gestational diabetes have an increased propensity to become overweight and also have a six-fold increase in T2DM risk.

Previous research has shown how telomeres, which are protective DNA sequences that protect the ends of chromosomes from degradation, are shorter in T2DM patients. This is also found in the child in cases of gestational diabetes. The scientists reasoned that this shortening may in fact occur during pregnancy and potentially be a causative factor for the development of T2DM later in life.

Using telomere length analysis technology developed at Cardiff University, the team were able to demonstrate male baby-specific telomere erosion in the placenta during gestational diabetes. Furthermore, additional analysis also determined that metformin and/or insulin treatment in the mother protects against this placental telomere shortening.

Researchers are hopeful that this increased understanding will allow for earlier, targeted interventions. Professor Rosalind John, leader of the research group, concluded: ‘‘…our research suggests that early adoption of targeted medical treatment in gestational diabetic pregnancies where the fetus is known to be male could offer an effective strategy for preventing adverse outcomes for children.’’ However, the researchers sounded a note of caution, acknowledging that their study featured a small sample size and more work in this field was required.