Snoring Pregnant Women at Higher Risk for Gestational Diabetes
June 11, 2009
June 11, 2009 (EurekAlert) - If you are pregnant and your mate complains your frequent snoring is rattling the bedroom windows, you may have bigger problems than an annoyed, sleep-deprived partner.
A new study from researchers at the Northwestern University Feinberg School of Medicine has found that women who reported frequent snoring during their pregnancy were more likely to develop gestational diabetes -- a condition than can cause health problems for the mother and baby. The study also found pregnancy increases the likelihood that a woman will snore.
This is the first study to report a link between snoring and gestational diabetes.
For the study, 189 healthy women completed a sleep survey at the time of enrollment (six to 20 weeks gestation) and in the third trimester.
Pregnant women who were frequent snorers had a 14.3 percent chance of developing gestational diabetes, while women who did not snore had a 3.3 percent chance. Even when researchers controlled for other factors that could contribute to gestational diabetes such as body mass index, age, race and ethnicity, frequent snoring was still associated with the disease.
Principal investigator Francesca Facco, M.D., a fellow at Northwestern's Feinberg School, will present her findings at the SLEEP 2009 23rd Annual Meeting of the Associated Professional Sleep Societies June 11.
"Sleep disturbances during pregnancy may negatively affect your cardiovascular system or metabolism," said Facco, who in August will become an assistant professor of obstetrics and gynecology at the Feinberg School and a maternal and fetal medicine physician at Northwestern Memorial Hospital.
"Snoring may be a sign of poor air flow and diminished oxygenation during sleep that can cause a cascade of events in your body," Facco said. "This may activate your sympathetic nervous system, so your blood pressure rises at night. This can also provoke inflammatory and metabolic changes, increasing the risk of diabetes or poor sugar tolerance."
The study also showed more women became frequent snorers as their pregnancies progressed. Early in pregnancy, 11 percent of women in the study reported frequent snoring; by the third trimester, the number rose to 16.5 percent. Frequent snoring was defined as snoring three or more nights a week.
Facco said snoring during pregnancy may be triggered by weight gain and edema (a buildup of fluid), which can increase airway resistance. Exactly how the snoring is linked to gestational diabetes is not yet known.
About 4 percent of pregnant women develop gestational diabetes, a condition in which women without previously diagnosed diabetes develop high blood sugar levels during pregnancy. Babies born to mothers with gestational diabetes are at increased risk of problems such as being large for gestational age, which may lead to delivery complications. These babies may also have low blood sugar levels and are at increased risk of becoming obese or developing impaired sugar tolerance or metabolic syndrome later in life.
While gestational diabetes usually resolves after pregnancy, women who develop it are at higher risk for type 2 diabetes later in life.
Facco said further studies are needed to understand the association between snoring and gestational diabetes and to develop interventions to treat sleep disorders during pregnancy.
"If snoring is bothering a woman who is pregnant, she should seek a consultation with a sleep specialist," Facco said.
In related study, also to be presented at the SLEEP 2009 meeting, Facco found sleep disturbances such as restless legs syndrome and insomnia increase significantly during pregnancy.
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Study Finds New Evidence of Periodontal Disease Leading to Gestational Diabetes
April 04, 2009
April 4, 2009 (EurekAlert) - A new study by NYU dental researchers has uncovered evidence that pregnant women with periodontal (gum) disease face an increased risk of developing gestational diabetes even if they don't smoke or drink, a finding that underscores how important it is for all expectant mothers – even those without other risk factors – to maintain good oral health.
The study, led by Dr. Ananda P. Dasanayake, Professor of Epidemiology & Health Promotion at New York University College of Dentistry in collaboration with the Faculty of Dental Sciences at the University of Peradeniya, Sri Lanka, eliminated smoking and alcohol use among a group of 190 pregnant women in the South Asian island nation of Sri Lanka, where a combination of cultural taboos and poverty deter the majority of women from smoking and drinking. The findings support an earlier study led by Dr. Dasanayake that found evidence that pregnant women with periodontal disease are more likely to develop gestational diabetes than pregnant women with healthy gums.
That study, which followed 256 women at New York's Bellevue Hospital Center through their first six months of pregnancy, showed that 22 of the women developed gestational diabetes. Those women had significantly higher levels of periodontal bacteria and inflammation than the other women in the study. The findings were published in the April 2008 issue of the Journal of Dental Research.
More than one-third of the women in the new study, which was conducted over the course of one year, reported having bleeding gums when they brushed their teeth. The women were given a dental examination and a glucose challenge test, which is used specifically to screen for gestational diabetes. According to Dr. Dasanayake, those women found to have the greatest amount of bleeding in their gums also had the highest levels of glucose in their blood. Dr. Dasanayake, who presented the findings today at the annual meeting of the International Association for Dental Research in Miami, said that he expected the final data to show that between 20 and 30 of the women had developed gestational diabetes.
Gestational diabetes is characterized by an inability to transport glucose -- the main source of fuel for the body -- to the cells during pregnancy. The condition usually disappears when the pregnancy ends, but women who have had gestational diabetes are at a greater risk of developing the most common form of diabetes, known as Type 2 diabetes, later in life. Asians, Hispanics, and Native Americans are at the highest risk for developing gestational diabetes. All of the women in the Sri Lanka study were of Asian origin, while 80 percent of the New York study subjects were Hispanic.
"In addition to its potential role in preterm delivery, evidence that gum disease may also contribute to gestational diabetes suggests that women should see a dentist if they plan to get pregnant, and after becoming pregnant," Dr. Dasanayake said. "Treating gum disease during pregnancy has been shown to be safe and effective in improving women's oral health and minimizing potential risks."
Posted by dlifenews at 10:15 AM | Comments (0)
Pregnancy Diabetes Doubles The Risk Of Language Delay In Children
November 06, 2008
November 6, 2008 (EurekAlert) - Children born to mothers with pregnancy-related diabetes run twice the risk of language development problems, according to a research team directed by Professor Ginette Dionne of Université Laval's School of Psychology. Details of this discovery are published in the most recent issue of the scientific journal Pediatrics.
Researchers compared the vocabulary and grammar skills of 221 children whose mothers were diagnosed with gestational diabetes to those of 2,612 children from a control group. These tests were conducted at different intervals between ages 18 months and 7 years.
Results showed that children born to mothers with gestational diabetes achieve poorer scores on tests of spoken vocabulary and grammar than children of healthy mothers. The differences between the two groups are probably due to the effects of gestational diabetes on the brain development of babies. The study shows that these effects persist even after the children start school.
This study is the first to isolate the effect of gestational diabetes from other factors including family socioeconomic status, alcohol and tobacco consumption as well as maternal hypertension during pregnancy.
However, the study suggests that the impact of pregnancy-related diabetes on language development is not inevitable, as children of more educated mothers appear less affected. "This protection may be the result of the more stimulating environment in which children of more highly educated mothers develop, but it could also be due to genes that could make some babies less vulnerable," explains Ginette Dionne. "For the moment, we cannot isolate the two factors, but ongoing studies should allow us to answer that question," she continued.
Between 2% and 14% of children are born to mothers who suffer from gestational diabetes. Risk factors for this complication during pregnancy include the mother's age and her body mass index. "As mothers are having their children at a later age and the incidence of obesity in the population is on the rise, the rate of gestational diabetes is clearly increasing," underlined Professor Dionne. "The risk to babies' language development needs to be taken into account," she concludes.
Posted by dlife at 10:33 AM | Comments (1)
Women With Gestational Diabetes At Risk Of Type 2 Diabetes
July 30, 2008
July 29, 2008 (Science Daily) - Women with gestational diabetes are at greater risk of developing type 2 diabetes, with almost 20% of women developing the condition within 9 years of pregnancy, found a large, population-based study of 659,000 women published in the Canadian Medical Association Journal.
The study, conducted by a group of researchers from the University of Toronto, Mount Sinai Hospital and the Institute for Clinical and Evaluative Sciences, looked at 21,823 women diagnosed with gestational diabetes and examined follow up records up to 9 years. They found the rate of diabetes increased rapidly in the first 9 months after delivery, peaking at 9 years.
"In this large, population-based study, we found that diabetes developed within 9 years after the index pregnancy in 18.9% of women with previous gestational diabetes; this rate was much higher than the rate among women without gestational diabetes (2%)," state Dr. Denice Feig and coauthors.
As well, they note that the rate of gestational diabetes in Ontario, the study province, seems to be increasing and is linked to older mothers. Living in low-income neighbourhoods and in urban areas were also risk factors for gestational diabetes. Higher urban statistics "may reflect the large numbers of South and East Asian and black populations living in urban areas, who have a higher risk of type 2 diabetes," postulate Dr. Feig and colleagues.
"The main strength of our study lies in the fact that it was a large population-based study involving more than 21,000 women with gestational diabetes, with up to 9 years of follow-up," state the researchers. "Unlike other studies, it covered a large, well-defined geographic region with a population of 13 million, which allowed us to make a more robust assessment of the risk of type 2 diabetes after gestational diabetes than has been possible in previous studies."
However, the study could not "assess the effect of ethnicity, obesity and level of fasting glucose during pregnancy, risk factors that are clearly associated with the development of diabetes."
"These women may benefit from both preventative interventions and regular screening," conclude the researchers who point out that physicians and policy makers need to counsel and screen these women accordingly.
In a related commentary, Dr. David Simmons of Cambridge University Hospitals NHS Foundation in the UK comments that many women with gestational diabetes become pregnant again, leading to potential risks for the fetus. "Type 2 diabetes in pregnancy, particularly if previously undiagnosed, is associated with poor outcomes, including an increased incidence of fetal loss, malformation and perinatal death." He argues for more investment in prevention and screening programs for at-risk women to protect women and their future children.
Posted by dlife at 10:38 AM | Comments (0)
NYU Dental Researchers Find Evidence of Periodontal Disease Leading to Gestational Diabetes
March 24, 2008
The findings, published in the April 2008 issue of the Journal of Dental Research, underscore how important it is for expectant mothers to maintain good oral health
March 24, 2008 (EurekAlert) - A study by a New York University dental research team has discovered evidence that pregnant women with periodontal (gum) disease are more likely to develop gestational diabetes mellitus than pregnant women with healthy gums.
The study, led by Dr. Ananda P. Dasanayake, a professor of epidemiology & health promotion at the NYU College of Dentistry, followed 256 women at New York’s Bellevue Hospital Center through their first six months of pregnancy. Twenty-two women developed gestational diabetes. Those women had significantly higher levels of periodontal bacteria and inflammation than the other women in the study.
The findings, published in the April 2008 issue of the Journal of Dental Research, underscore how important it is for expectant mothers to maintain good oral health.
“In addition to its potential role in preterm delivery, evidence that gum disease may also contribute to gestational diabetes suggests that women should see a dentist if they plan to get pregnant, and after becoming pregnant,” says Dasanayake. “Treating gum disease during pregnancy has been shown to be safe and effective in improving women’s oral health and minimizing potential risks.”
“In the future,” he added, “we can expect to see more research on the link between these two conditions involving other high risk groups, such as Asian and Native American women.”
Gestational diabetes is characterized by an inability to transport glucose -- the main source of fuel for the body -- to the cells during pregnancy. The condition usually disappears when the pregnancy ends, but women who have had gestational diabetes are at a greater risk of developing the most common form of diabetes, known as Type 2 diabetes, later in life. Hispanics, Asians, and Native Americans are at the highest risk for developing gestational diabetes. Eighty percent of the women in the NYU study were Hispanic.
Inflammation associated with periodontal disease is believed to play a role in the onset of gestational diabetes, perhaps by interfering with the normal functioning of insulin, the hormone that regulates glucose metabolism.
Posted by dlife at 09:16 AM | Comments (0)
Sleep Apnea Increases Risk of Diabetes and Hypertension in Pregnant Women
May 23, 2007
May 23, 2007 (EurekAlert) —Sleep apnea is associated with a greatly increased incidence of pregnancy-induced diabetes and high blood pressure, according to a study presented at the American Thoracic Society 2007 International Conference, on Wednesday, May 22.
The study found that when the women’s weight was taken into account, sleep apnea was associated with a doubling of the incidence of gestational diabetes and a fourfold increase in the risk of pregnancy-induced hypertension.
In obstructive sleep apnea, the upper airway narrows, or collapses, during sleep. Periods of apnea end with a brief partial arousal that may disrupt sleep hundreds of times a night. Obesity is a major risk factor for sleep apnea.
The most effective treatment for sleep apnea is an apparatus called nasal CPAP, for contin¬u¬ous posi¬tive airway pres¬sure, which delivers air through a mask while the patient sleeps, keeping the airway open.
The researchers analyzed data from all pregnancies associated with sleep apnea, gestational diabetes (women who developed diabetes during pregnancy) and pregnancy-induced high blood pressure nationwide in 2003. Out of almost 4 million deliveries, 452 had sleep apnea. Of the 167,227 women who had gestational diabetes, 67 had sleep apnea. Of the 200,902 pregnancies with pregnancy-induced high blood pressure, 166 had sleep apnea.
“The repetitive decrease in oxygen that occurs during the night in someone with sleep apnea heightens the body’s ‘fight or flight’ state, which can raise blood pressure,” explains researcher Hatim Youssef, D.O. of UMDNJ-Robert Wood Johnson Medical School. “The body also secretes more hormones such as cortisol and epinephrine, and the body responds by producing more glucose coupled with a decreased sensitivity to insulin, which can lead to diabetes.”
Pregnancy can worsen sleep apnea, especially during the third trimester when a woman’s weight is greatest, Dr. Youssef explains. “When a mother’s oxygen level drops at night, it may also affect the oxygen level of the fetus, and we don’t know what the long-term effects are. That’s why it’s important for a pregnant woman with sleep apnea to be treated with CPAP during her pregnancy.”
It is not yet known whether CPAP treatment can reduce the risk of diabetes and hypertension during pregnancy, he says. “In the non-pregnant population, research has shown that treating sleep apnea will reduce the risk of diabetes and hypertension. In the future, we want to follow pregnant women whose sleep apnea is well-controlled to see if treatment prevents them from developing these conditions, or makes it less severe.”
He recommended that pregnant women who are obese, hypertensive or diabetic be closely evaluated for the presence of sleep apnea.
If sleep apnea is present, treatment in the form of nasal CPAP should be used and her blood pressure and blood sugar should be closely monitored, Dr. Youssef says.
Posted by dlifenews at 10:15 AM | Comments (0)
History of Gestational Diabetes Raises Lifelong Diabetes Risk in Mother and Child
April 25, 2006
Lifestyle Changes Can Prevent Or Delay Later Diabetes
April 25, 2006 (NIH News) - "It's Never Too Early to Prevent Diabetes", the latest diabetes prevention campaign message by the National Diabetes Education Program (NDEP), is spreading the word about the risk for type 2 diabetes faced by women with a history of gestational diabetes mellitus (GDM) and their offspring. On April 25th the NDEP joined Deputy Surgeon General, RADM Kenneth P. Moritsugu and Griffin P. Rodgers, M.D., acting director of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), one of the National Institutes of Health (NIH), in Washington to announce this latest message in an ongoing national public awareness effort. The NDEP is jointly sponsored by the NIH and the Centers for Disease Control and Prevention, agencies of the U.S. Department of Health and Human Services.
"It's Never Too Early to Prevent Diabetes" is the latest addition to NDEP's campaign, "Small Steps. Big Rewards. Prevent type 2 Diabetes", the nation's first comprehensive multicultural type 2 diabetes prevention campaign. The campaign offers materials that can help women with a history of GDM take steps to prevent or delay type 2 diabetes and help their children lower their risk for the disease. Available campaign materials include a tip sheet in English and Spanish for women who have had GDM, a tip sheet in English and Spanish for children at risk for type 2 diabetes, and a booklet for adults to help women and their families make healthy food choices and be more physically active to prevent or delay type 2 diabetes. These materials are available on the NDEP website at www.ndep.nih.gov.
"Mothers who've had GDM need to know that they and their children have an increased lifelong risk for developing type 2 diabetes," explained Moritsugu. "The risk doesn't go away. By making modest lifestyle changes to lose a small amount of weight, usually by making healthy food choices and being more physically active, women can help prevent or delay the disease. Children can lower their risk for type 2 diabetes by not becoming overweight or obese."
GDM is a form of glucose intolerance that occurs during pregnancy. GDM affects about 7 percent of all U.S. pregnancies annually, resulting in approximately 200,000 cases a year. After pregnancy, 5 to 10 percent of women who had GDM continue to have type 2 diabetes. Women with a history of GDM have a 20 to 50 percent chance of developing diabetes in the future, and their children are at increased risk for obesity and diabetes during childhood and adolescence compared to other children.
The Diabetes Prevention Program (DPP), an NIDDK-funded clinical trial, found that people at increased risk for type 2 diabetes can prevent or delay the onset of the disease by losing 5 to 7 percent of their body weight through increased physical activity and a low fat, low calorie eating plan. The DPP included several hundred women with a history of GDM, and the powerful reduction in risk of diabetes demonstrated in the study -- up to 58 percent -- was found in all subgroups including this group of women.
"Diabetes prevention is proven, possible, and powerful," said Dr. Rodgers. "Small steps like eating fresh fruits and vegetables and whole grains, taking the stairs instead of the elevator, and playing with your kids in the park can yield a lifetime of healthy rewards for the entire family."
Recent reports have shown high or increasing rates for GDM in various parts of the country, including:
-- Washington, D.C, where in 2003 the GDM prevalence rate in Hispanic women was 12 percent -- close to the highest rate of 14 percent seen in some American Indian women.
-- New York City, where the GDM prevalence rate increased 46 percent from 1990 to 2002 -- with the highest increase found among Asian women.
-- Colorado, where the GDM prevalence rate increased 95 percent from
1994 to 2002 -- with the highest among Hispanic women.
-- Northern California, where the number of new cases each year increased 35 percent from 1991 to 2000.
These regional GDM prevalence rates raise concern that the increase may reflect the ongoing pattern of increasing obesity and contribute to the upsurge in cases of diabetes in the U.S.
The NDEP has materials for health care professionals and people at risk for diabetes -- including older adults, American Indians and Alaska Natives, Hispanics/Latinos, African Americans, and Asian Americans and Pacific Islanders. For more information about the NDEP or to obtain a copy of the new "It's Never Too Early to Prevent Diabetes" and "Nunca es muy temprano para prevenir la diabetes" tip sheets and other "Small Steps. Big Rewards." diabetes prevention materials, visit www.ndep.nih.gov or call 1-800-438-5383.
The U. S. Department of Health and Human Services' National Diabetes Education Program is jointly sponsored by the National Institutes of Health and the Centers for Disease Control and Prevention with the support of more than 200 partner organizations.
The National Institutes of Health (NIH) -- "The Nation's Medical Research Agency" -- includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. It is the primary federal agency for conducting and supporting basic, clinical and translational medical research, and it investigates the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit www.ndep.nih.gov.
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