Type 2 diabetes after pregnancy
This discovery could lead to a test that would help doctors identify patients at greatest risk and help them potentially avert the disease through interventions including diet and exercise.
The research was led by Michael Wheeler, a professor of physiology at U of T's Faculty of Medicine, in collaboration with Hannes Röst, an assistant professor of molecular genetics and computer science at the Donnelly Centre for Cellular and Biomolecular Research, Feihan Dai, a research scientist of physiology and Erica Gunderson, a research scientist at the Kaiser Permanente Division type 2 diabetes after pregnancy Research in Northern California. Mi Lai, a post-doctoral fellow in Wheeler's group performed much of the analyses.
The identified metabolic signature can predict with over 85 per cent accuracy if a woman will develop type 2 diabetes T2Das described in a study published in the journal Plos Medicine.
About one in 10 women will develop gestational diabetes GD during pregnancy which puts them at higher risk of T2D, with 30 to 50 per cent of these women developing the disease within 10 years after delivery. The disease hampers the body's ability to regulate blood sugar levels and can lead to serious complications type 2 diabetes after pregnancy vision loss, neurological problems, as well as heart and kidney disease.
Women with GD are recommended to have an annual oral glucose tolerance test after delivery, which measures the body's ability to remove sugar from the bloodstream. But the procedure is time and labor consuming and fewer than half of the women follow through with it. All of the women delivered their babies at Kaiser Permanente Northern California hospitals between and The new study builds on prior research, following the same cohort of women over a longer time period during which more women developed T2D.
Baseline blood samples were collected between six and nine weeks after birth and then twice over two years.
The women's health was followed through their electronic medical records for up to 8 years. During this time, women developed T2D and their blood samples were compared to women enrolled in the study, matched for weight, age, race and ethnicity, who had not developed the disease.
Röst said that, unsurprisingly, sugar molecules feature prominently among the identified compounds.
But amino-acids and lipid molecules are also present, indicating underlying issues in protein and fat metabolism, respectively.
In fact, the predictive power of the test dropped if amino-acids and lipids were excluded, suggesting that processes beyond sugar metabolism may occur very early in the development of the disease. The finding may help explain why complications occur in T2D patients even when blood sugar is tightly controlled with medications.
What are my chances of getting type 2 diabetes if I have gestational diabetes? Can I prevent it?
The researchers hope to turn their discovery into a simple blood test that women could take soon after delivery, perhaps during an early visit to the doctor with their baby. The test is intended to help obstetricians and primary care providers identify the women with recent gestational diabetes who are most at risk for developing type 2 diabetes and to support them with breastfeeding and other healthful lifestyle habits during the first year postpartum that may reduce their risk.
Kevéssé ismert azonban a terhesség hatása a betegség hosszútávú kimenetelére. Nem tisztázottak a gesztációs diabétesz GDM késői anyai következményei sem. Jelen vizsgálatban hasonló módszerekkel pregesztációs 1-es és 2-es típusú diabéteszben és korábban GDM-ben szenvedő kGDM asszonyokat vizsgáltunk évekkel szülésük után. A terhességük előtt is cukorbeteg asszonyokban gyakori a túlsúly, a hypertonia és a dohányzás. A kGDM kohorszban összefüggést találtunk a glukóz intolerancia GI súlyossága és a metabolikus szindróma gyakorisága között.