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Joslin study sheds light on birth defect cause in pregnant women with diabetes

BOSTON The babies of women with diabetes are two to five times more likely to develop birth defects than offspring of women without the disease. A recent study in animals by scientists at Joslin Diabetes Center in Boston helps explain why. The research, appearing in the October issue of the American Journal of Physiology: Endocrinology and Metabolism, suggests that high blood glucose levels early in pregnancy deprive the embryo of oxygen, interfering with its development.

"Until recently, it was not understood how diabetic pregnancy could cause birth defects. My laboratory wanted to explore this research because the more we know about the effects of the mother's diabetes on the embryo, the more tools we have to identify therapies that may prevent birth defects in diabetic pregnancy," says the study's lead investigator, Mary R. Loeken, Ph.D., an investigator in Joslin's Section on Developmental and Stem Cell Biology and Assistant Professor of Medicine at Harvard Medical School.

Women with both type 1 and type 2 diabetes run a high risk of having babies with birth defects, especially of the heart and spinal cord. Because these organs form during the first few weeks of pregnancy, coinciding with the time that a woman may first learn she is pregnant, aggressive control of blood glucose levels just before and after conception is critical. "Women with diabetes should be consulting with their healthcare team to be sure they have good glycemic control before becoming pregnant," says Dr. Loeken. Maintaining blood glucose control continues to be important throughout the pregnancy, but it is particularly important during the first eight weeks, when an embryo's organs are forming.

In addition to recommending that women with diabetes have good control of their glucose levels before becoming pregnant, Dr. Loeken recommends that obese women who don't know if they have diabetes but who are planning to become pregnant be tested for diabetes. There have been
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4-Oct-2005


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