Risk of childhood diabetes may begin in womb: study

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This article was published 17/07/2018 (1715 days ago), so information in it may no longer be current.

The risk of childhood diabetes may begin in the womb, concludes a new Canadian study that calls for doctors to screen women of First Nations descent early in their pregnancies.

The Children’s Hospital Research Institute of Manitoba study found a child’s risk of early onset diabetes is related to whether the mother had diabetes while pregnant, along with the form of the disease she had, and whether she’s of First Nations descent.

The research institute and the University of Manitoba jointly released the findings Tuesday. The study was published June 11 in JAMA Pediatrics, an American Medical Association journal.

Type 2 diabetes is at epidemic levels among Indigenous people. First Nations on reserve have a rate of diabetes three to five times higher than other Canadians, with rates also rising among Canadian Inuit. The rising rates have been related to obesity, physical inactivity and unhealthy eating habits, according to federal statistics.

The study ties in pregnancy as another risk factor.

“Type 2 diabetes is increasing worldwide and is disproportionately affecting First Nations people,” researcher Brandy Wicklow said in a formal statement.

The study found the risk a child would develop diabetes was one to two times higher with a First Nations mother who had gestational diabetes. The risk soared to five to six times the rates of non-First Nations children if the mother had type 2 diabetes during pregnancy.

First Nations children as young as four have been diagnosed with type 2 diabetes, a disease usually diagnosed in Canadian youth only when they’re in their teens or 20s.

Wicklow, an assistant pediatrics and child health professor in the Max Rady College of Medicine with the University of Manitoba, said the study was conducted to help doctors better identify early-life and intergenerational factors that lead to type 2 diabetes.

“The findings have implications for future research and clinical practice guidelines, including early pregnancy screening and follow up of children,” Wicklow said.

The study was based on a university research database held by the University Centre for Health Policy of nearly a half-million Manitoba children born between 1984 and 2008, from birth until 30 years of age.

Currently, doctors don’t automatically screen women for the risk of diabetes when they become pregnant.

Provincial guidelines allow for tests after 28 weeks of pregnancy. The study says such testing should be done well before 20 weeks.

The study findings also suggest diagnoses of gestational diabetes may be more the result of when doctors test for diabetes, rather than when women develop the condition.

“By default, most women are labelled as having ‘diabetes in pregnancy,’ whether it’s gestational diabetes or type 2 diabetes,” Wicklow said.

Alan Katz, director of the Manitoba Centre for Health Policy and a professor in the department of community health science and family medicine at Max Rady College, called the findings exciting but unique.

“Their reason for calling for tests is not what happens in pregnancy, it’s for what happens after pregnancy. So, I’m not sure that study will lead to a change in policy, quite frankly. Often these changes take time and they require more than one study before they filter down into clinical practice,” he said.

The study included 89,231 First Nations children (1,796 of whom were exposed to type 2 diabetes and 1,527 to gestational diabetes in the womb), along with 378,619 non-First Nations offspring (1,992 of who were exposed to type 2 diabetes and 2,504 of whom were exposed to gestational diabetes).

alexandra.paul@freepress.mb.ca