Gestational diabetes­–a type of diabetes that develops during pregnancy–is on the rise. From 2000 to 2010, the percentage of pregnant women with gestational diabetes increased 56 percent, according to the CDC.

Given the increasing prevalence of gestational diabetes, Tim Garvey, MD, principal investigator of the NIH-funded UAB Diabetes Research Center and Associate Director of the UAB Comprehensive Diabetes Center, and a team of researchers set out to understand its effects on mother and child.

“Our research aimed to discover how the in-utero environment can program metabolism in the offspring to increase the risk of obesity and cardiometabolic disease,” said Garvey.  Both neonates and children 4-10 years of age were studied, and their mothers were either lean or had obesity, during gestation, or developed gestational diabetes during the pregnancy.  We had several significant findings that will not only grow our knowledge of gestational diabetes, but also open the door for future research.”

Garvey and the team of UAB researchers gathered clinical data on the enrolled pair of mother and child, such as weight, height, blood pressure, A1C, insulin, physical activity level, and epigenetic modifications of the children’s DNA that could have arisen during gestation. The team included:

• Department of Nutrition Sciences Associate Professor Paula Chandler-Laney, Ph.D.
• Department of Epidemiology Associate Professor Bertha Hidalgo, Ph.D.
• Department of Epidemiology Data Analyst Nita Kanney
• UT Austin Department of Women’s Health Associate Professor and Division Chief Lorie Harper, M.D.
• Department of Obstetrics and Gynecology Assistant Professor Ashley Battarbee, M.D.
• Division of Endocrinology, Diabetes and Metabolism Associate Professor Kirk Habegger, Ph.D.
• Post-Doctoral Fellow Samantha Martin
• Graduate Student Bethany Moore, and others

Through this gathered data set, the team has recently reported on three distinct research projects. The first published article in the peer-reviewed journal Metabolites engaged an advanced technique of analysis on the mother-child pairs: using blood samples to estimate epigenetic age of both the mother and the child.

Epigenetic age is measured by DNA methylation, which can then be evaluated using Horvath and Hannum clocks. Epigenetic age is not always the same as the stated age of an individual. For instance, a 25-year-old may have a greater epigenetic age due to lifestyle habits such as smoking or consistent exposure to high stress.

In this study, first author Kanney, working with expert epidemiologist Hidalgo and team, were seeking to uncover potential associations between gestational diabetes and epigenetic age acceleration. Ultimately, the team found that mothers with gestational diabetes had a higher predicted epigenetic age and age acceleration than mothers without gestational diabetes.

The team’s second study, published in the Human Kinetics Journal, examined associations among physical activity, adiposity, and insulin resistance in children exposed to gestational diabetes. First author Moore, working with Chandler-Laney, performed a secondary analysis and determinants of physical activity were assessed.

Ultimately, the team found that children’s physical activity is related to current weight status but not underlying risk for obesity. They also noted that physical activity may be especially important to reduce obesity and insulin resistance in high-risk children. Reducing obesity and insulin resistance are both key elements in prevention and treatment of diabetes.

Garvey and team also published a third study from the research that examined the effects of gestational diabetes on children’s cardiometabolic health.

First Author Martin noted that the study aimed to test the hypothesis that with a pregnancy complicated by obesity and gestational diabetes, women and children would have greater adiposity and poorer cardiometabolic health.

Using a cross-sectional study, researchers found that although greater adiposity among children exposed to gestational diabetes is evident at 4-10 years, there were no discovered differences in cardiometabolic health at that age range. It is likely that cardiometabolic disease traits arise after puberty consistent with previous publications.

All three research projects were made possible by the support of several research grants, such as the American Heart Association's Strategically Focused Research Network on Obesity (17SFRN336101011) and the UAB Diabetes Research Center and Nutrition Obesity Research Center, funded by the National Institutes of Health (NIH; DK079626, DK056336).

In addition to grant funding, generous donations to the UAB Comprehensive Diabetes Center (UCDC) make cutting-edge diabetes research, comprehensive education and training, and breakthroughs that ultimately improve the lives of those affected by diabetes in our community and beyond, possible.