Diabetes fight focuses on pregnant women

Authorities aim to cut risk for next generation by preventing gestational diabetes mellitus

Many people who are obese or diabetic are afflicted by these conditions because their mothers had gestational diabetes mellitus while carrying them. PHOTO: ST FILE

Many people who are obese or diabetic are afflicted by these conditions because their mothers had gestational diabetes mellitus (GDM) while carrying them.

Three out of four babies born to such mothers will be severely obese or diabetic some time in their lives, said Sir Peter Gluckman, chief scientific officer of the Singapore Institute for Clinical Sciences (SICS), which is part of the Agency for Science, Technology and Research.

The National University Hospital (NUH) hopes to reduce the rate of obesity and diabetes in the next generation of Singaporeans by preventing GDM, or diabetes caused by the stress of pregnancy.

Associate Professor Chong Yap Seng of the National University Health System said a trial called Nipper, which started at NUH in the middle of last year and plans to recruit 600 women, aims to use balanced nutrition to prevent these women from getting this disease.

Sir Peter, also a principal investigator in Gusto, a longitudinal baby study at NUH and the KK Women's and Children's Hospital (KKH) that started in 2009, said the rate of GDM in Singapore is very high.

Based on Gusto, one in five of 1,136 pregnant women here tested had GDM, more than double the 9.2 per cent in the United States. This was even though half of the Singapore women were thought to be at low risk and would normally not have been checked for it.

Prof Chong, also SICS executive director, said doctors here were surprised at the high rate of GDM in Singapore.

The finding has led KKH and the Singapore General Hospital (SGH) to test all pregnant women for GDM from January. NUH plans to start testing later this year.

If left uncontrolled, GDM can cause a host of problems including premature birth. Women who get this disease tend to already be somewhat insulin-resistant.

GDM can disappear after the baby is born. But Sir Peter, who is the co-chair of the World Health Organisation's Commission on Ending Childhood Obesity, said women with GDM will need to be careful after they give birth, as many of them will become diabetic unless they exercise and watch their diet.

Prof Chong added that women with GDM are more than seven times as likely as other women to get diabetes. The Gusto study found 10 per cent of these women developed full-blown diabetes within five years of childbirth, when they were only in their 30s.

This has alerted all hospitals here to monitor women with GDM for diabetes in the years after childbirth.

The study showed that the rate of GDM here is far higher in Indian and Chinese mothers than in Malay mums. Sir Peter said Indians are of particular concern, as some Indian babies are born with more "bad fat" than others.

He said: "By the age of 41/2 years, Indian children have shown signs that they are well on the pathway to insulin resistance and diabetes."

Sir Peter, who is chief science adviser to New Zealand Prime Minister John Key, is confident that Singapore is in a good position to correct the situation.

He said: "It's being taken seriously in Singapore, which knows diabetes is a top public health problem. And Singapore has always been willing to invest heavily in children."

Correction note: An earlier version of the story wrongly stated the month that KKH and SGH started testing all pregnant women for GDM. We are sorry for the error.

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A version of this article appeared in the print edition of The Straits Times on March 29, 2016, with the headline Diabetes fight focuses on pregnant women. Subscribe