Treating Gestational Diabetes May Reduce Childhood Obesity

August 30, 2007 — Treating gestational diabetes mellitus (GDM) during pregnancy may reduce the child’s risk of becoming obese, according to the results of a study in the September issue ofDiabetes Care.

“Diabetes in pregnancy is associated with an increased rate of offspring childhood obesity, impaired glucose tolerance, and type 2 diabetes,” write Teresa A. Hillier, MD, MS, from the Center for Health Research, Kaiser Permanente Northwest in Portland, Oregon, and colleagues. “We sought to determine whether increasing hyperglycemia in pregnancy, ranging from normal to GDM, is related to childhood obesity in offspring during the typical period of adiposity rebound in a diverse population.”

The offspring of mothers with GDM by National Diabetes Data Group criteria that was treated had a lower risk for childhood obesity than did those with lesser degrees of hyperglycemia that was untreated. The pattern was similar for whites vs nonwhites, as well as in children of normal birth weight (≤ 4000 g).

“Our results in a multiethnic US population suggest that increasing hyperglycemia in pregnancy is associated with an increased risk of childhood obesity,” the study authors write. “More research is needed to determine whether treatment of GDM may be a modifiable risk factor for childhood obesity.”

Limitations of the study include evaluation of only a subsample of the birth cohort who remained members and had weights measured at age 5 to 7 years, inability to determine how previous maternal obesity may have contributed to the hyperglycemia observed in pregnancy, and classification of maternal hyperglycemia based on GDM screening at 1 time point in pregnancy.

“These results suggest that metabolic imprinting of the child for future obesity occurs in women with GDM (not only in those with preexisting diabetes), and, thus, GDM screening might have long-term benefits to offspring,” the study authors conclude. “They also suggest that GDM treatment may decrease the risk of childhood obesity and provide an additional reason for screening for GDM in pregnancy.”

The American Diabetes Association supported this study. The costs of publication of this article were defrayed in part by the payment of page charges, mandating that it must therefore be marked “advertisement.”

Diabetes Care. 2007;30:2287-2292.

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