Latest news with #JoslinDiabetesCenter
Observer
15-04-2025
- Health
- Observer
Study links diabetes in pregnancy to developmental risks
Maternal diabetes, a pregnancy complication that can affect up to a third of women globally, is linked with a higher risk of neurodevelopmental issues in children, a large new study found. The study, which was published last week in the journal Lancet Diabetes & Endocrinology, adds to a growing body of evidence that ties maternal diabetes to a range of health complications for both the mother and the child. Though the findings describe only a correlation, experts said the data underscored the need for screening and early treatment of diabetes, a condition that is becoming more common worldwide. In the United States, an estimated 10% of women had diagnosed diabetes in 2021, and 9% of pregnant American women develop gestational diabetes every year. 'We've known for some time that there's some link between elevated glucose levels in pregnancy and future neurodevelopmental disorders,' said Dr. Elizabeth Halprin, who is chief of adult diabetes at the Joslin Diabetes Center in Boston and was not involved in the study. The new findings speak 'to the need to control diabetes during pregnancy,' she added. The analysis, which pooled data from 202 studies on more than 56 million pregnancies around the world, examined outcomes for children whose mothers had Type 1 or Type 2 diabetes while pregnant, or were diagnosed with gestational diabetes. These conditions are collectively referred to as 'maternal diabetes.' Even when studies accounted for other factors like a woman's age or body mass index, children born to women who had diabetes during pregnancy were 28% more likely to have a neurodevelopmental issue than children whose mothers didn't have the disease. The risks of ADHD and intellectual disability were slightly higher compared with those of other issues, like autism. The analysis found a greater likelihood of neurodevelopmental disorders in children of women who were diabetic before pregnancy, compared with those who had gestational diabetes. Having gestational diabetes for a longer period or having gestational diabetes severe enough to warrant medication also increased the risk. The consistency of the associations is surprising, given how large and diverse the data set was, said Fangkun Liu, an author of the paper and an associate professor of neurosurgery at Central South University in Changsha, China. It's not clear what might be behind the potential link between high blood sugar levels and neurodevelopmental issues. The study's authors suggest that Type 1 diabetes, an autoimmune condition, may increase inflammation in children, correlating with increased risk of autism and ADHD. Maternal diabetes also affects how genes are expressed and could cause changes that affect brain function, they said. Doctors have also known for years that high blood sugar increases the risk of neurological birth defects, including spina bifida and a condition called anencephaly, when the brain isn't fully developed. It is thereforen't surprising that high blood sugar might affect other types of neurological development, too, said Dr. Susan Spratt, a professor of endocrinology at the Duke University School of Medicine. The study 'does not establish diabetes as a direct cause' of neurodevelopmental disorders, Liu said, because it was difficult to account for all confounding factors, particularly genetics. Some studies in the analysis looked at siblings and found no clear link between maternal diabetes and neurodevelopmental issues. Both Halprin and the authors noted that the new study didn't include much data from low-income countries, such as those in South and Southeast Asia, where maternal diabetes is more prevalent. The biggest unanswered question is whether getting blood sugar under control could cut these potential risks. 'As a researcher, a physician in this space, as well as a parent, I want to now know more about the impact of glucose control treatment in pregnancy,' said Dr. Kartik Venkatesh, who is the director of the Diabetes in Pregnancy Program at Ohio State University and was not involved in the study. The authors called for more rigorous research into this question. Several experts said the study points to the need for comprehensive diabetes screening among young women in their 20s and 30s, so that anyone who may get pregnant receives treatment before they conceive. An estimated 4% of U.S. women had undiagnosed diabetes in 2021. The American Diabetes Association recommends that women with diabetes meet with an endocrinologist or a specialist in maternal-fetal medicine when planning to conceive. In addition to controlling their blood sugar before and during pregnancy, some patients may need to stop taking certain drugs, such as medications called sulfonylureas, which are known to cross the placenta and are typically not recommended during pregnancy. There is little research on the effects of drugs like Ozempic during pregnancy. The ADA recommends that pregnant patients with diabetes receive nutrition counseling that promotes a diet of whole grains, lean protein, and fresh fruits and vegetables. Exercise can help improve glucose levels and reduce the need for insulin, which is the preferred medication for managing diabetes in pregnancy. While the findings can seem concerning, Venkatesh said, 'the reality of diabetes care in pregnancy is we have treatments that work.' This article originally appeared in
New York Times
07-04-2025
- Health
- New York Times
New Study Links Diabetes in Pregnancy to Developmental Risks in Children
Maternal diabetes, a pregnancy complication that can affect up to a third of women globally, is linked with a higher risk of neurodevelopmental issues in children, a large new study found. The study, which was published in the journal Lancet Diabetes & Endocrinology on Monday, adds to a growing body of evidence that ties maternal diabetes to a range of health complications for both the mother and the child. Though the findings describe only a correlation, experts said the data underscored the need for screening and early treatment of diabetes, a condition that is becoming more common worldwide. In the United States, an estimated 10 percent of women had diagnosed diabetes in 2021, and 9 percent of pregnant American women develop gestational diabetes every year. 'We've known for some time that there's some link between elevated glucose levels in pregnancy and future neurodevelopmental disorders,' said Dr. Elizabeth Halprin, who is chief of adult diabetes at the Joslin Diabetes Center in Boston and was not involved in the study. The new findings speak 'to the need to control diabetes during pregnancy,' she added. The analysis, which pooled data from 202 studies on more than 56 million pregnancies around the world, examined outcomes for children whose mothers had Type 1 or Type 2 diabetes while pregnant, or were diagnosed with gestational diabetes. These conditions are collectively referred to as 'maternal diabetes.' Even when studies accounted for other factors like a woman's age or body mass index, children born to women who had diabetes during pregnancy were 28 percent more likely to have a neurodevelopmental issue than children whose mothers didn't have the disease. The risks of A.D.H.D. and intellectual disability were slightly higher compared with those of other issues, like autism. The analysis found a greater likelihood of neurodevelopmental disorders in children of women who were diabetic before pregnancy, compared with those who had gestational diabetes. Having gestational diabetes for a longer period of time or having gestational diabetes severe enough to warrant medication also increased the risk. The consistency of the associations is surprising, given how large and diverse the data set was, said Fangkun Liu, an author of the paper and an associate professor of neurosurgery at Central South University in Changsha, China. It's not clear what might be behind the potential link between high blood sugar levels and neurodevelopmental issues. The study's authors suggest that Type 1 diabetes, an autoimmune condition, may increase inflammation in children, correlating with increased risk of autism and ADHD. Maternal diabetes also affects how genes are expressed and could cause changes that affect brain function, they said. Doctors have also known for years that high blood sugar increases the risk of neurological birth defects, including spina bifida and a condition called anencephaly, when the brain isn't fully developed. It therefore isn't surprising that high blood sugar might affect other types of neurological development, too, said Dr. Susan Spratt, a professor of endocrinology at the Duke University School of Medicine. The study 'does not establish diabetes as a direct cause' of neurodevelopmental disorders, Dr. Liu said, because it was difficult to account for all confounding factors, particularly genetics. Some studies in the analysis looked at siblings and found no clear link between maternal diabetes and neurodevelopmental issues. Both Dr. Halprin and the authors noted that the new study didn't include much data from low-income countries, such as those in South and Southeast Asia, where maternal diabetes is more prevalent. The biggest unanswered question is whether getting blood sugar under control could cut these potential risks. 'As a researcher, a physician in this space, as well as a parent, I really want to now know more about the impact of glucose control treatment in pregnancy,' said Dr. Kartik Venkatesh, who is the director of the Diabetes in Pregnancy Program at Ohio State University and was not involved in the study. The authors called for more rigorous research into this question. Several experts said the study points to the need for comprehensive diabetes screening among young women in their 20s and 30s, so that anyone who may get pregnant receives treatment before they conceive. An estimated 4 percent of U.S. women had undiagnosed diabetes in 2021. The American Diabetes Association recommends that women with diabetes meet with an endocrinologist or a specialist in maternal-fetal medicine when planning to conceive. In addition to controlling their blood sugar before and during pregnancy, some patients may need to stop taking certain drugs, such as medications called sulfonylureas, which are known to cross the placenta and are typically not recommended during pregnancy. There is little research on the effects of drugs like Ozempic during pregnancy. The A.D.A. recommends that pregnant patients with diabetes receive nutrition counseling that promotes a diet of whole grains, lean protein and fresh fruits and vegetables. Exercise can help improve glucose levels and reduce the need for insulin, which is the preferred medication for managing diabetes in pregnancy. While the findings can seem concerning, Dr. Venkatesh said, 'the reality of diabetes care in pregnancy is we have treatments that work.'
Yahoo
24-02-2025
- Health
- Yahoo
Diabetes 'medalist' has lived with the disease for 80 years
When he was 10 and newly diagnosed with diabetes, Julian 'Yudi' Rubin and his mother were told he wouldn't live past 30 and wouldn't be able to father children. He'll be 90 this spring, an occasion he expects to celebrate with his son, his daughter, his six grandchildren and five great-granddaughters. Defying the odds has been Rubin's lifelong endeavor, one that's earned the New London native and former Waterford resident a string of medals. Earlier this month, the Boston-based Joslin Diabetes Center recognized him for 'his outstanding lifetime achievement in living courageously with type I diabetes for 80 years.' Five years ago, he was similarly honored with a 75-year medal. Before that, there was the 50-year medal. Joslin has so far tracked down 36 diabetes survivors who have reached the 80-year milestone, according to John Gauthier, the Joslin researcher who traveled to New Jersey to present Rubin with his latest medal. The presentation was made at the Rockleigh nursing home where Rubin's resided since last year, after he moved to an affiliated assisted-living facility in 2022. His daughter, Amy Kagedan, a special educator, lives in Teaneck, N.J. His son Mitchell lives in Norwich. Rubin lived on Laurel Crest Drive in Waterford for decades, having grown up on Linden Street in New London. He attributes his longevity 'to living in the present,' he said last week during a virtual interview. 'And I've lived in a manner I would call 'doing it my way,'' he said. 'As far as the diabetes went, it didn't ruin my life as it does for many. ... I did things a doctor wouldn't recommend.' When he went to work in the family business, the Ruby Glass Co., in New London, he could have opted to go out on measuring jobs, say, or sit behind a desk. Instead, he chose to work in the shop, on his feet all day, handling huge pieces of glass weighing as much as 200 pounds. 'Because the work was so hard I burned up a lot of the carbohydrates I was eating,' he said. 'I could feel when my blood sugar was rising or falling,' which is crucial for a diabetic taking insulin, a medication that manages blood sugar levels. 'I would get slight cuts from handling raw glass, a no-no for a diabetic, but I wanted to do it my way,' he said. He worked for 45 years, retiring at age 64. Rubin said he never considered being diabetic a problem, accepting the condition as 'part of my life.' A doctor who treated him at Lawrence + Memorial Hospital in New London for 18 years is convinced Rubin's attitude has served him well. 'Julian was the embodiment of true self-actualization, whose personality traits helped him deal effectively with his diabetes and other challenges during his life,' Dr. Stephen Quevedo, former director of the Joslin affiliate at L+M, wrote to Kagedan on the occasion of Rubin's receiving the 80-year medal. 'One does not achieve such an incredible milestone without a combination of good fortune and genes, but I truly believe his demeanor played the largest role. Rubin also benefited from the support of his family and the medical community at a time when little was known about diabetes. He recalled events that led to his diagnosis in 1945, beginning with his suffering from a virus that sent him to the Mitchell Quarantine Center on Colman Street in New London. Following his discharge, he began experiencing other symptoms at home. He developed an appetite for candy and was 'thirsty all the time' while frequently urinating. At some point, he slipped into a coma. Dr. Isadore Hendel, the family's doctor, had Rubin's parents take him to L+M, where he was diagnosed and stabilized with insulin. 'L+M saved my dad's life,' Kagedan said. 'But they didn't have the knowledge or infrastructure to teach him how to take care of himself. They sent him to Joslin.' Enter Rubin's mother, Faye, who stayed with him for two weeks in Boston, studying about type I diabetes as he learned to give himself injections. Later, she advised him to keep three tin foil-wrapped cubes of sugar in his pocket in case he sensed his blood sugar dropping. Rubin's wife, Dolores, who died in 2019, also was instrumental in his living with diabetes. 'I was married to the most wonderful woman for 64 years,' he said. 'She always had me in the back of her mind. It was very seldom she had to remind me what to do, but in a quiet way she was always there. That's the best way to treat a person who needs special care.' Gauthier, the Joslin researcher who presented Rubin with his 80-year medal, said studies of the medalists have aided diabetes research. Awareness and treatment of the disease was pretty much nonexistent when, in 1948, Joslin began recognizing people who had been living with diabetes for 25 years. Joslin began awarding 50-year medals in 1970, and added the 75-year medal in 1996 and the 80-year medal in 2013. Medals have been awarded to recipients in all 50 states and throughout the world, including Australia, Canada, England, Finland, Hungary, Japan, the Netherlands, Pakistan, the Philippines, Russia, Spain, Sweden, Switzerland, South Africa and South America. More than 6,150 medals have been awarded since 1970, Gauthier said. 'If somebody is diagnosed with type 1 diabetes today, they can have a very positive outlook for the rest of their life,' he said. 'If they get support from doctors and family, they can live a relatively normal life.'
