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Madrid, Spain — Swiftly achieving glycemic control after a diagnosis of gestational diabetes can significantly reduce the risk of childhood obesity to levels comparable to those seen in children of mothers without gestational diabetes, according to new research presented at the annual meeting of the European Association for the Study of Diabetes (EASD) held from September 9-13 in Madrid.
Gestational diabetes, a condition that can develop during pregnancy, affects approximately 14% of pregnant women globally. It is increasingly prevalent among individuals who are obese, have a family history of diabetes, or are older, with race and ethnicity also influencing risk.
Although gestational diabetes typically resolves after birth, it poses several risks for both mother and child. Mothers are at a heightened risk of developing diabetes in the future, while their children face increased chances of premature birth, large-for-gestational-age weight, neonatal hypoglycemia, and long-term cardiometabolic issues such as obesity and diabetes.
Dr. Assiamira Ferrara, Director of the Center for Upstream Prevention of Adiposity and Diabetes Mellitus at Kaiser Permanente Northern California, presented the findings, highlighting that “achieving glycemic control soon after the diagnosis of gestational diabetes and maintaining it through pregnancy, up to delivery, is associated with reduced rates of perinatal complications.”
Dr. Ferrara and her team examined data from 258,064 women who gave birth in the U.S. between 2011 and 2023, focusing on 17,316 women diagnosed with gestational diabetes. They categorized glycemic control into four groups: stably optimal (39.2%), rapidly improving to optimal (32.3%), slowly improving to near optimal (16.7%), and slowly improving to suboptimal (11.8%).
Childhood obesity, defined as a sex-specific BMI-for-age ≥95th percentile, was assessed at ages 2-4 and 5-7. The prevalence of obesity at age 2-4 was 15.1% in children of mothers without gestational diabetes. In comparison, the rates for children of mothers in the stably optimal, rapidly improving to optimal, slowly improving to near optimal, and slowly improving to suboptimal glycemic control groups were 15.9%, 18.7%, 20.9%, and 24.6%, respectively.
The study found that children of mothers with gestational diabetes who achieved stably optimal and rapidly improving to optimal glycemic control had a similar risk of obesity to those whose mothers did not have gestational diabetes. In contrast, children of mothers with less effective glycemic control had higher obesity risks: 13% higher in the slowly improving to near optimal group and 23% higher in the slowly improving to suboptimal group. At ages 5-7, only children from the stably optimal group maintained a similar risk of obesity as those from non-gestational diabetes backgrounds.
Dr. Ferrara emphasized the importance of managing gestational diabetes effectively: “When gestational diabetes is not properly managed, it increases the baby’s risk of high birth weight and predisposes them to obesity. However, if the mother’s blood sugar is quickly controlled, her baby’s risk of childhood obesity can be comparable to that of children whose mothers had normal blood sugar during pregnancy.”
She advises women diagnosed with gestational diabetes to promptly follow their treatment plan, which typically includes dietary changes, exercise, and glucose monitoring. If blood sugar levels remain outside the recommended range within two weeks, medication should be introduced as prescribed.
Reducing the risk of obesity is crucial, as obesity increases the likelihood of developing diabetes and heart disease, conditions that are challenging to reverse once established. Dr. Ferrara’s findings underscore the critical role of early and effective management of gestational diabetes in safeguarding long-term health outcomes for both mothers and their children.
