NEW YORK: The mainstream understanding of diabetes developing in a pregnant woman — known as gestational diabetes — is that the largest problem it can lead to is simply a large, unusually “fat” baby.
But any type of diabetes in a pregnant woman poses a variety of much more complex threats to a growing fetus.
A recent study published in the American Journal of Physiology-Cell Physiology reports a significantly higher risk of heart disease in babies born to women with gestational diabetes. Gestational diabetes is similar to type 2 diabetes in that it is not an autoimmune condition like type 1 diabetes, but instead a metabolic disorder.
“Previous research has found that levels of a protein called transgelin are higher in offspring of women with gestational diabetes,” explained the recent report. “Transgelin is found in the endothelial colony of forming cells (ECFCs) that line the walls of blood vessels.”
When researchers from the Indiana University School of Medicine compared blood samples taken from the umbilical cords of babies born to women with gestational diabetes versus babies born to nondiabetic women, the higher levels of transgelin and protein levels demonstrated a very clear dysfunction in the development of healthy blood cells.
These cells are critical for both wound healing and for building blood vessel “networks,” a crucial part of a human’s overall cardiovascular system.
Without healthy and adequate ECFCs, the long-term development of that child’s blood vessel health can be significantly impaired and lead to a diagnosis of heart disease later in life.
“It’s not surprising,” explains Jennifer Smith, a certified diabetes educator and pregnancy coach for patients with diabetes at Integrated Diabetes Services. “Higher blood glucose levels in a pregnant woman pose a significant risk to the formation of every critical system in the development of a fetus.”
Gestational diabetes is generally diagnosed during the 2nd or 3rd trimester, explains Smith, as pregnancy-related hormones and overall body weight both rise, which leads to varying levels of insulin resistance.
“While it isn’t entirely known why gestational diabetes develops in some women and not others, the risk factors — including women over 25 years old, with a family history of type 2 diabetes, and a body mass index over 30 — definitely increases the likelihood in any pregnant woman,” explains Smith, co-author of “Pregnancy with Type 1 Diabetes.”
After diagnosis, however, mitigating the risks it poses to a growing fetus is very doable and ultimately comes down to the pregnant mother. Taking several short walks each day after eating and focusing on a diet made up mostly of whole, real foods can have a tremendous impact on overall insulin sensitivity and blood glucose levels.
“If you’ve been diagnosed with gestational diabetes, you can have a healthy pregnancy and a healthy baby, but the goal is to immediately start managing your blood glucose levels closely with a glucometer as soon you become aware of the issue,” explains Smith.
Even aside from the most recent research on the baby’s future risk of heart disease, Smith adds that babies born to a woman with gestational diabetes are also at risk for preterm birth, abnormally large birth weights, respiratory distress syndrome, low blood glucose levels during the first few hours or days of life immediately after birth, and a much higher risk for developing type 2 diabetes later in life.
“Whether a woman has been diagnosed with gestational diabetes or not, healthy habits and healthy blood glucose levels reduce a pregnant woman’s risk of high blood pressure, pre-eclampsia, and their own long-term diagnosis of type 2 diabetes.”
The Centers for Disease Control & Prevention reports that as many as 10 percent of pregnant women develop gestational diabetes, and 50 percent of those women go on to maintain that level of insulin resistance, which leaves them with a diagnosis of type 2 diabetes.
The baby’s healthcare team should also be paying close attention to their heart health over the first decade of their life in order to prevent any small issues from becoming far larger.
“Unfortunately, these [conditions] often go undiagnosed until children present with disease later in life, at which time the opportunity for prevention has ended,” explained researchers.
This new understanding of the risk gestational diabetes poses to a child’s evolving heart health means primary care doctors can monitor them more closely and refer these patients to cardiologists for further testing if concerns arise.