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Does Gestational Diabetes Cause Autism

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Gestational Diabetes Is Linked To Autism Risk

Dr. Max Gomez: Gestational Diabetes And Autism

A new study of more than 320,000 babies links autism to gestational diabetes.

The longitudinal study, conducted between 1995 and 2009 by researchers at Kaiser Permanente Southern California, found that children born to mothers who developed gestational diabetes before 26 weeks of pregnancy were at a 63 percent increased risk of being diagnosed with autism spectrum disorder. But after controlling for maternal age, education, ethnicity, household income, the childs sex and the mothers pre-existing conditions, that risk dropped to 42 percent.

While the overall rate of autism among study participants was 1 in 100 , the rate of autism among children born to mothers with early pregnancy diabetes was 1 in 80.

Because this is a longitudinal association study, researchers were not able to establish a cause for the autism diagnosis. However, the associations were strong enough to warrant at least two health applications for expectant parents, according to study co-author Dr. Edward Curry.

For one, the studys results emphasize the importance of early prenatal care. The women whose children were most at risk for developing autism were not women with previously diagnosed type 2 diabetes . Nor were they women who got gestational diabetes after 26 weeks. Instead, the link between early gestational diabetes and an increased likelihood of autism diagnosis could mean that a fetus early exposure to uncontrolled high blood sugar may somehow affect brain development.

High Blood Sugar Might Interfere With Normal Brain Development Researcher Says

TUESDAY, April 14, 2015 — Pregnancy-related diabetes may increase the risk a child will develop autism, new research suggests.

The blood sugar disorder, known as gestational diabetes, was linked to a moderately increased risk for an autism spectrum disorder in a study of more than 320,000 U.S. children, said study researcher Anny Xiang, director of statistical research at Kaiser Permanente Southern California.

However, it was an “observational study” and cannot prove a direct cause-and-effect relationship between gestational diabetes — which affects up to 9 percent of pregnant women in the United States — and autism.

“To provide perspective, this increased risk seen with early gestational diabetes translated to around seven additional cases per 1,000 pregnancies over that seen with pregnancies that didn’t involve diabetes,” Xiang said.

No increased risk of autism was associated with type 2 diabetes diagnosed before pregnancy, the study found.

One expert urged caution in interpreting the findings.

“Although this study suggests that development of gestational diabetes during the first or second trimester of pregnancy puts a fetus at increased risk for an autism spectrum disorder, the magnitude of this risk — if real — is relatively small,” said Dr. Andrew Adesman, chief of developmental and behavioral pediatrics at the Cohen Children’s Medical Center of New York in New Hyde Park, N.Y.

But Adesman isn’t so sure about that.

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Explaining The Correlation Between Gestational Diabetes And Autism

Gestational diabetes and autism what is the correlationWhy do then women who are newly diagnosed with diabetes and under 26th week of pregnancy have the higher risk?

Although, it was not revealed in the research why gestational diabetes increases autism risk in children, the authors, however, believe that diabetic condition, which affects bodys blood sugar level, interferes with the development of foetus brain. If the blood sugar level remains untreated it damages blood vessels, which is detrimental for the foetus of less-than 26 weeks.

Expecting mothers who were already diagnosed with diabetes and under treatment, therefore, do not have increased the risk of having a child with autism, explained Anny Xiang, the lead author.

Anny Xiang and team, from;Kaiser Permanente;Southern California Department of Research and Evaluation, used data collected from more than 300,000 children born between 1995 and 2009 for their research. Out of the total, 9.8 percent of children were exposed to high blood sugar level. Out of which, 7.8 percent were exposed through gestational diabetes and the remaining 2 percent of the childrens mother had Type II diabetes. About 1 percent of the children exposed to diabetes were diagnosed with autism at a later age.

However, the researchers claim their study to be significant as it points to;a probable cause for the autism spectrum disorder. The study shows controlling blood sugar level is necessary to reduce autism risk.

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Characteristics Of Asd Studies

18 studies measuring ASD were identified; three of these also measured ADHD. Table provides a summary of their characteristics and findings. Nine of these studies were from North America. Four were from middle income countries; none were from low- income countries . All studies were observational. Most of the studies used medical records or parental report of ASD and GDM; diagnostic criteria for GDM were usually not reported. 11 of the studies were assessed as high risk of bias due to lack of information about how GDM or ASD was diagnosed, increasing the risk of measurement bias and/or lack of information about selection criteria preventing accurate assessment of risk of selection bias.

Table 1 Summary of studies measuring ASD.

Sensitivity analyses

In the meta-analysis of ORs for ASD, it appeared that effect sizes were slightly larger for those studies at low to moderate risk of bias. However, removal of the two studies at high risk of bias from the meta-analysis resulted in little change. Indeed, the pooled OR was slightly reduced at 1.39 . There were insufficient numbers of studies to facilitate the same sensitivity analysis for ADHD.

Diabetes In Pregnant Women May Raise Autism Risk In Children

Does Gestational Diabetes Cause Autism

Children born to mothers with diabetes, which is known to complicate pregnancy, are likely to have an increased risk of developing autism spectrum disorder , claims a new study.

ASD is a condition related to brain development that impacts how a person perceives and socialises with others, causing problems in social interaction and communication.

The study, by researchers including Anny H. Xiang from the Kaiser Permanente – a US-based health care company – showed that the risk is associated with Type-1 , Type-2 and gestational diabetes.

The results showed that risk of ASD was higher in children exposed in utero to maternal preexisting T1D, T2D and gestational diabetes diagnosed by 26 weeks compared with no maternal diabetes exposure.

The severity of maternal diabetes and the timing of exposure may be associated with the risk of autism in children of mothers with diabetes, Xiang said.

The study, published in the journal JAMA, included data from 4,19,425 children who were born at 28 to 44 weeks from 1995-2012. They looked at how exposure to all three types of maternal diabetes was associated with diagnosis of ASD, which includes autistic disorders, Asperger syndrome and pervasive developmental disorder among the children.

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Maternal Gestational Diabetes Linked To Autism Risk For Offspring

A team of researchers states that intrauterine exposure to gestational diabetes mellitus is associated with an increased risk of autism spectrum disorders.

However, the children of mothers who had pre-existing type 2 diabetes did not have an increased risk of developing autism spectrum disorders , according to the study published in JAMA.

Gestational diabetes mellitus is a condition whereby a mothers glucose tolerance is impaired with onset or first recognition during pregnancy. According to a study conducted by the Centers for Disease Control and Prevention from 2007-10, GDM prevalence in the US is as high as 9.2%.

Previous research has identified a number of health risks for children born to mothers with GDM, including significantly larger than average birth weight , low blood sugar levels at birth and an increased risk of developing impaired glucose tolerance.

Long-term, studies have also suggested that the exposure of fetuses to maternal hyperglycemia in mothers with pre-existing diabetes and mothers developing GDM could result in a long-term risk of obesity and other related metabolic disorders.

Meta-analyses have shown some evidence of a significant association between exposure to maternal diabetes and risk of ASD in offspring, write the authors. Less information is available on the association of exposure to maternal GDM with risk of ASD.

Growing Baby Growing Impact

Gestational diabetes affects the mother in late pregnancy, after the baby’s body has been formed, but while the baby is busy growing. Because of this, gestational diabetes does not cause the kinds of birth defects sometimes seen in babies whose mothers had diabetes before pregnancy.

However, untreated or poorly controlled gestational diabetes can hurt your baby. When you have gestational diabetes, your pancreas works overtime to produce insulin, but the insulin does not lower your blood glucose levels. Although insulin does not cross the placenta, glucose and other nutrients do. So extra blood glucose goes through the placenta, giving the baby high blood glucose levels. This causes the baby’s;pancreas;to make extra insulin to get rid of the blood glucose. Since the baby is getting more energy than it needs to grow and develop, the extra energy is stored as;fat.

This can lead to macrosomia, or a “fat” baby. Babies with;macrosomia;face health problems of their own, including damage to their shoulders during birth. Because of the extra insulin made by the baby’s pancreas, newborns may have very low blood glucose levels at birth and are also at higher risk for breathing problems. Babies born with excess insulin become children who are at risk for;obesity;and adults who are at risk for;type 2 diabetes.

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Gestational Diabetes Mellitus Prenatal Air Pollution Exposure And Autism Spectrum Disorder

There were interactions of prenatal and early-life exposure to O3 with maternal diabetes.

Greater first trimester exposure to O3 was associated with increased risk of ASD only in early onset GDM.

No O3 associations with ASD were observed in other categories of maternal diabetes.

GDM onset early in pregnancy may increase susceptibility to prenatal O3-associated ASD risk.

These hypothesis-generating findings need to be replicated in future studies.

Gestational Diabetes In Pregnancy May Raise Child’s Risk Of Autism

Is there a link between gestational diabetes and autism?

Pregnancy-related diabetes may increase the risk a child will develop autism, new research suggests.

The blood sugar disorder, known as gestational diabetes, was linked to a moderately increased risk for an autism spectrum disorder in a study of more than 320,000 U.S. children, said study researcher Anny Xiang, director of statistical research at Kaiser Permanente Southern California.

However, it was an “observational study” and cannot prove a direct cause-and-effect relationship between gestational diabetes — which affects up to 9 percent of pregnant women in the United States — and autism.

“To provide perspective, this increased risk seen with early gestational diabetes translated to around seven additional cases per 1,000 pregnancies over that seen with pregnancies that didn’t involve diabetes,” Xiang said.

No increased risk of autism was associated with type 2 diabetes diagnosed before pregnancy, the study found.

One expert urged caution in interpreting the findings.

“Although this study suggests that development of gestational diabetes during the first or second trimester of pregnancy puts a fetus at increased risk for an autism spectrum disorder, the magnitude of this risk — if real — is relatively small,” said Dr. Andrew Adesman, chief of developmental and behavioral pediatrics at the Cohen Children’s Medical Center of New York in New Hyde Park, N.Y.

Mothers-to-be should get their blood sugar checked early in pregnancy, Xiang said.

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Data Extraction And Risk Of Bias Assessment

Two independent reviewers extracted data, including study characteristics, prevalence and odds ratios and any information on mechanisms for the associations. Study authors were e-mailed to request raw data if potentially relevant data may be available.

Risk of bias in all included studies was also assessed by two independent reviewers using a pre-piloted modified Newcastle Ottawa Scale . Scores for selection bias and measurement bias were of particular interest as most of the studies were of observational design. Each question in the tool had a score of zero to two . A score of two on any item within the selection and measurement bias domains meant that the study was categorised as having a high risk of bias.

Rna Sequencing And Differential Expression Analysis

RNA-seq bioinformatics Adapters were trimmed from sequences using cutadapt tool . Reads that were shorter than 40 nucleotides or that mapped to rRNA sequences were removed. TopHat was used to align the remaining reads to the mm10 genome. All libraries had at least 20 million uniquely aligned reads to the genome. Read counting to Refseq genes was done with HTseq-count using the intersection_strict option, followed by differential expression analysis with DESeq2 using the options betaPrior FALSE, cooks Cutoff FALSE and independent Filtering FALSE . Raw P values were adjusted for multiple testing using the procedure of Benjamini and Hochberg. Gene ontology analysis on differentially expressed genes was performed using the Toppgenetool . Supplementary Table includes all genes, their fold change, and adjusted P values.

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Chances Of Autism Due To Gestational Diabetes

The risk of autism is more in the case of women who get gestational diabetes in early diabetes. If diabetes is diagnosed at the 26th week or even before then there is more possibility of autism. However, the risk factor is quite less. It is around 1.5 %.

During the early stages of the pregnancy, the brain of the child develops. But if the mother develops diabetes at this stage then it can affect the developmental activities of the brain and it can lead to autism. This happens due to excess glucose in the body. Sometimes it might cause inflammation in the brain also.

What Do These Autism

Does Gestational Diabetes Cause Autism

Do these studies prove that diabetes, especially when combined with obesity, causes autism in some babies?

One of the mantras of science is that correlation does not equal causation. But discovering a correlation can be the first step in proving a cause and effect. One important factor in establishing a cause and effect is whether there’s a scientific reason why something, in this case diabetes, might cause, contribute to, or trigger autism.

“Research is uncertain as to how, but theories include hyperglycemia in the mother,” explained Svena Julien, MD, assistant professor of gynecology and obstetrics at Johns Hopkins Medicine in Baltimore. “Glucose is toxic to many tissues, including the developing fetal brain.

To combat damage caused by high sugar, Dr. Julien explained, the body releases other substances that cause inflammation, which itself is potentially harmful. Having excess body fat, which sometimes goes along with diabetes, also can create chronic inflammation, according to some researchers.13

Besides triggering inflammation, diabetes also could reduce the amount of oxygen a fetus gets.14 In short, diabetes influences the levels of insulin, oxygen, and inflammation in the womb, changing the environment in which the fetal brain is forming, Dr. Xiang’s research group theorized.

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Comparison With Previous Studies

In accordance with previous studies, we showed that PGDM is associated with an increased risk of ASD in offspring.,,, Xiang et al. observed an association between GDM and risk of ASD after stratification by gestational week at diagnosis and observed that exposure at 26wkGA was associated with the greatest risk of ASD., Conversely, we found that exposure to cases diagnosed between 27 and 30wkGA was associated with the greatest risk for ASD, though this difference may relate to the strategies for GDM screening in the two different healthcare setting. Few previous studies have investigated the association between maternal diabetes and ID in offspring., Mann et al. found a stronger association between PGDM and ID in offspring compared with GDM, consistently with our results for ID. A handful of studies have previously investigated the association between maternal diabetes and ADHD,,,, with results largely consistent with our own, though Xiang et al. reported no associations between GDM and ADHD, even after the timing of exposure was considered.

Here Are 6 Things About Gestational Diabetes You Need To Know Now

1. It has nothing to do with your body weight

Yes, obesity is a factor which affects your risk of developing gestational diabetes, but not all obese women will develop this condition. Gestational diabetes is a condition which has more to do with your body’s ability to process glucose than your body weight. Besides this, your body’s sensitivity to insulin decreases during pregnancy.Also read:;Your Body Weight Can Affect Your Chances Of Getting Pregnant

2. You may not need insulin

Not all women with gestational diabetes need insulin. Instead, most of them may successfully achieve normal blood sugar levels with the help of a balanced diet and proper physical activity. Even if insulin is required, a small dose is enough. Larger doses can be painful for the mother. She can take 4 small doses of insulin in a day. Recent studies suggest that oral medications can also be beneficial for women with gestational diabetes.Also read:;Insulin Resistance: Causes, Symptoms And Prevention

3. You need not go through a c-section delivery

Gestational diabetes does not necessarily mean that you would have to go through a cesarean delivery. Some women, who fail to manage gestational diabetes properly, may have to go through a c-section delivery. The rest can have uncomplicated vaginal deliveries. The key to normal vaginal deliveries is proper management of gestational diabetes.

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What Happens When A Mother Has Obesity And Diabetes

Across the country, researchers launched two similar diabetes-autism studies, but with a few crucial differences. One group studied a group of mothers in Boston with a higher rate of obesity and diabetes than average.2 Being obese raises the risks of developing Type 2 diabetes12 and gestational diabetes.6

“The global epidemics of obesity and diabetes affect all ages, including pregnant women,” said Xiaobin Wang, MD, one of the researchers. They wondered: Did having both conditions produce a combined effect that was greater than having just diabetes or obesity alone?

It did. According to this study, mothers who had diabetes and obesity before pregnancy were four times more likely to have a child with autism. Moms who had obesity and gestational diabetes were three times more likely to have a child with ASD. The Boston study was smaller than the one from Kaiser Permanente. Researchers analyzed the pregnancies of 2,734 women; 102 of their babies eventually were diagnosed with autism.2

The majority of those women were low-income, black or Hispanic. Do the results apply to mothers in other economic, racial or ethnic groups? “Maybe,” said Dr. Wang, a professor at the Johns Hopkins Bloomberg School of Public Health. “The association between diabetes and ASD was seen across many studies of different populations,” she said.

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