NEW YORK (AP) -- A new, large study suggests that treating
women who develop diabetes during pregnancy greatly reduces the chances that
their baby will become obese during childhood.
The research found that the higher the mother's blood sugar levels, the greater
the child's risk of being obese by age 5 to 7, even if the mother wasn't
diagnosed with diabetes.
Untreated high blood sugar nearly doubled the child's risk of becoming
overweight or obese, said the study's lead author, Dr. Teresa Hillier of Kaiser
Permanente's Center for Health Research in Portland, Ore.
That higher risk disappeared, however, when women with diabetes followed a
special diet, exercised or were given insulin. Their children had about the same
risk of becoming obese as those whose mothers had normal blood sugar, the
researchers found.
"The important message is that the risk of child obesity related to gestational
diabetes is potentially reversible," said Hillier, adding that high blood sugar
during pregnancy is contributing to the nation's epidemic of childhood obesity.
The research, funded by the American Diabetes Association, is in the September
issue of the group's journal, Diabetes Care.
Gestational diabetes begins during pregnancy and usually goes away after
childbirth. It affects 3 to 8 percent of pregnant women in the United States.
The mother's elevated blood sugar can cause the fetus to grow too large,
sometimes requiring delivery by Caesarean section and can bring on other health
problems for the mother and baby.
Whether a mother's high blood sugar can lead to childhood obesity has been less
clear. It was seen in a study of Pima Indians and in some studies of other
populations, the researchers said.
Dr. Boyd Metzger of Northwestern University said the Kaiser research complements
a study he presented earlier this summer that suggests lowering the threshold
for a diabetes diagnosis. His study found the higher the mother's blood sugar,
the greater the risk of complications for the newborn, even at levels below the
cutoff for diabetes.
The new study "just provides further evidence that we should be making changes
in the diagnosis," said Metzger.
Kaiser patient Janelle Peterson said she worried about getting diabetes when she
was pregnant in 2001 with her first son, Erick, because of a family history of
diabetes.
"I dreaded it because I knew it was going to happen," said Peterson, who lives
outside Portland in the town of Scappoose.
With the help of a nutritionist, Peterson said she struggled to change her diet
and keep her blood sugar low. During her second pregnancy with now 3-year-old
Christian, she needed to use insulin.
"I had to keep telling myself, I'm doing it for my baby, I'm doing it for a
healthy baby and I'm doing it for myself," she said.
Peterson said the effort paid off; today both of her sons are healthy and don't
have weight problems.
For their study, Hillier and her colleagues analyzed medical records for 9,439
patients in Oregon, Washington and Hawaii who gave birth between 1995 and 2000
and were all screened for diabetes. Their children were weighed between ages 5
and 7.
Of the children whose mothers had normal blood sugar levels, 24 percent were
overweight and 12 percent were obese. For untreated high blood sugar, 35 percent
of the children were overweight and 20 percent were obese.
In the treated diabetes group, 28 percent of the children were overweight and 17
percent were obese. The researchers found no statistical difference between the
treated and normal level groups after taking into account other contributing
factors for childhood obesity -- including the mother's age, weight gain during
pregnancy, size of the baby and ethnicity.
They calculated that children from the untreated highest levels were 89 percent
more likely to be overweight and 82 percent more likely to be obese, compared to
children whose mothers had normal levels. Even those children who had normal
birth weights were at increased risk of obesity, the researchers said.
