Glucose tolerance of offspring of mother with gestational diabetes mellitus in a low-risk population
ABSTRACT To describe the prevalence of impaired glucose tolerance and obesity in offspring of mothers whose pregnancies were complicated by gestational diabetes mellitus (GDM) in a low-risk population and to investigate the effect on these outcomes of minimal intervention compared with tight control for management of GDM.
Eighty-nine children (mean age 9.1 years, 93% Caucasian) were recruited through a follow-up study of women previously involved in a randomized controlled trial of minimal intervention (control group) vs. tight glycaemic control (treatment group) for GDM. Fasting blood glucose (FBG) and 2-h glucose tolerance tests (2hGTT) were performed on offspring and body mass index (BMI) calculated. Glucose tolerance and BMI of treatment groups were compared using non-inferiority tests (non-inferiority margin -15%).
Of those offspring, 6.9% (5/72) had abnormal glucose metabolism [four children had impaired glucose tolerance (IGT) and one had Type 2 diabetes mellitus (DM) (all Caucasian)]. Of the four children with IGT, three were male, three had normal BMI, and three had a family history of Type 2 diabetes. Of the 71 offspring who underwent 2hGTT, 25/25 (100%) of the control offspring and 46/46 (100%) of the treatment offspring had normal FBG (FBG < 5.7 mmol/l). Twenty-five of 25 (100%) of control and 42/46 (91.3%) of the treatment offspring had normal glucose tolerance (2hGTT < 7.8 mmol/l) (% difference 8.7, 95% CI -5.6, 20.3). BMI < 85th percentile was found in 25/33 (75.8%) of the treatment group and 44/52 (84.6%) of the control group (difference in percentage -8.9, 95% CI -27.2, 7.8).
School-age children of mothers with GDM are at risk of IGT and overweight, even if from a low-risk ethnic population. FBG was not adequate for screening this population. Minimal intervention for glycaemic control in GDM pregnancies appears to be as effective as tight control for preventing IGT in childhood but not for preventing obesity.
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- "Ferraro and Adamo Clinical Medicine: Pediatrics 2008:2 an overweight/obese child (Pettitt et al. 1983; Petittetal, 1985; Pettitt et al. 1987; Pettitt et al. 1993; Noussitou et al. 2005; Rosenberg et al. 2005; Schaefer-Graf et al. 2005; Malcolm et al. 2006; Allen et al. 2007; Chu et al. 2007; de Campos et al. 2007). The resulting implications of increased maternal adiposity and the corresponding risk this has on the child's future health must be addressed. "
ABSTRACT: Global increases in obesity have led public health experts to declare this disease a pandemic. Although prevalent in all ages, the dire consequences associated with maternal obesity have a pronounced impact on the long-term health of their children as a result of the intergenerational effects of developmental programming. Previously, fetal under-nutrition has been linked to the predisposition to pediatric obesity explained by the adiposity rebound and ‘catch-up’ growth that occurs when a child born to a nutrient deprived mother is exposed to the obesogenic environment of present day. Given the recent increase in maternal overweight/obesity (OW/OB) our attention has shifted from nutrient restriction to overabundance and excess during pregnancy. Consideration must now be given to interventions that could mitigate pregravid body mass index (BMI), attenuate gestational weight gain (GWG) and reduce postpartum weight retention (PPWR) in an attempt to prevent the downstream signaling of pediatric obesity and halt the intergenerational cycle of weight related disease currently plaguing our world. Thus, this paper will briefly review current research that best highlights the proposed mechanisms responsible for the development of child OW/OB and related sequalae (e.g. type II diabetes (T2D) and cardiovascular disease (CVD)) resulting from maternal obesity.Clinical Medicine: Pediatrics 01/2008;
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ABSTRACT: Ecosystems generally have a great number of interacting processes, and their characteristics can vary rapidly across both space and time. With such complexity, it can be difficult to collect sufficient data to adequately understand the behaviour of the observed system. This paper describes a method being used to examine the relationship between sampling accuracy and classification fuzziness. A simulation model acts as a surrogate for a “real-world” resource-habitat system. Samples are collected from the running simulation according to different classification schemes, and the ability to map species habitat by resource levels from each sample are compared to the actual simulation behaviour. The balance between sampling accuracy and the vagueness within the classification scheme compared to the complexity of the modelled system is discussedFuzzy Information Processing Society, 1999. NAFIPS. 18th International Conference of the North American; 08/1999