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Risk of type 2 diabetes begins in utero, study

Posted:  Tuesday, December 16, 2014

The risk of developing diabetes in later life could be traced back to where life begins. A new study added to emerging evidence that the risk of developing type-2 diabetes, obesity, and cardiovascular disease is affected by intra-uterine exposure.

Researchers from Lund University have found that exposure to gestational diabetes (GDM) in utero is a major risk factor that increases the possibility of the offspring developing obesity and diabetes later in life. The results of this study were published in the journal Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy.

The current guidelines to prevent type 2 diabetes tend to focus on lifestyle modification and in some cases pharmacological intervention. However, in the light of the present findings, the researchers emphasise the need for updated guidelines, which incorporate the foetal programming events occurring in pregnancy into the risk equation.

The foetal programming hypothesis is based on the view that the intrauterine milieu provided to the growing foetus determines the trajectory of disease risk later. The researchers observed that the relationship between intrauterine nutrition, birth weight (a marker of foetal nutrition) and diabetes risk is U-shaped. This means that offspring born from under- or over-nourished pregnancies would be at a greater risk of diabetes than those born to moderately nourished pregnancies.

"This review describes the evidence showing that there are other factors that may be intervened upon much earlier in life, and serves as a precursor to upcoming work,” said the researchers. The researchers found that consistent high blood sugar levels during pregnancy also seemed to be harmful for the foetus.

In conclusion, the researchers suggest that limiting weight gain and bringing about minor reductions in gestational glucose concentrations could bring about a positive effect. It is also important to educate the mother about how her diet choices during pregnancy could impact her child’s health. As more research focusing on foetal epigenetics is underway, there could soon be biomarkers to identify primordial defects in pregnancy or in early childhood.

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