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https://www.med.cuhk.edu.hk/press-releases/cuhk-recommends-oral-glucose-tolerance-test-for-all-pregnant-women-study-reveals-children-of-women-with-gestational-diabetes-mellitus-have-3-fold-diabetes-risk
https://www.med.cuhk.edu.hk/press-releases/cuhk-recommends-oral-glucose-tolerance-test-for-all-pregnant-women-study-reveals-children-of-women-with-gestational-diabetes-mellitus-have-3-fold-diabetes-risk

CUHK Recommends Oral Glucose Tolerance Test for All Pregnant Women Study Reveals Children of Women with Gestational Diabetes Mellitus Have 3-Fold Diabetes Risk

A recent study conducted by the Faculty of Medicine at The Chinese University of Hong Kong (CUHK) found that the risk of developing prediabetes or diabetes for children born to mothers who suffered from gestational diabetes mellitus (GDM) is 3 times that of those who were born to mothers with normal blood glucose level.  These children also have a 50% higher rate of overweight and obesity.  Researchers recommend all pregnant women to take an oral glucose tolerance test (OGTT) for diagnosis of GDM, so that mothers can adjust their living habits or receive treatments to reduce the impact of GDM on both themselves and their offspring.  The study results have been published in the leading international medical journal Diabetes Care in May 2017. 

 

At least 20% of local pregnant women suffer from GDM

Pregnant women usually have a slightly higher blood glucose level for development of the fetus.  However, hormonal changes in pregnant women may also lead to insulin resistance resulting in a higher glucose level, a condition known as GDM.  Asians are a high-risk group for diabetes and GDM.  Pregnant women with other risk factors like obesity (Body Mass Index, BMI, before pregnancy ≥ 25 kg/m2), advanced maternal age (35 years old or above), multiple pregnancy, having given birth to baby(ies) weighing over 4kg and having family history of diabetes, are more likely to suffer from GDM.  Rapid weight gain due to excessive intake of nutrients during pregnancy can also lead to GDM.  According to the figures in 2016, it is estimated that at least 20% of pregnant women in Hong Kong have GDM, significantly higher than the 12% recorded 25 years ago.

 

GDM could be diagnosed by OGTT.  According to international definition, a pregnant woman is diagnosed with GDM if her fasting plasma glucose level ≥ 5.1 mmol/L, 1-hour plasma glucose level ≥ 10.0 mmol/L, or 2-hour plasma glucose level ≥ 8.5 mmol/L. GDM is associated with several adverse outcomes, e.g. pre-eclampsia, macrosomia, preterm delivery, polyhydramnios, and in some cases caesarean section is necessary. The recent research by CUHK reveals that GDM is also associated with cardiometabolic risk in the next generation.

 

Study proves GDM increases offspring’s risk of overweight and obesity by 50%

Between 2009 and 2013, the Department of Obstetrics and Gynaecology, Department of Medicine and Therapeutics, and Department of Paediatrics of the Faculty of Medicine at CUHK followed up on the cases of around 1,000 mothers who had joined the ‘Hyperglycemia and Adverse Pregnancy Outcome’ (HAPO) study together with their children of an average age of 7 years.  Results are as follows:

 

 Children born to mother with GDM (132 persons)Children born to mother with normal glucose tolerance  (794 persons)
Suffer from prediabetes or diabetes4.7%1.7%
Overweight and obesity22.7%15.3%

 

Results show that the risk of developing prediabetes or diabetes for the children born to mothers with GDM is 3 times that of other children of the same age.  Their rate of overweight and obesity is also 50% higher.  In addition, the research team found that for each degree of increase in 1-hour plasma glucose level (equivalent to 1.6 mmol/l), corresponding consequences in their offsprings include:

 

• risk of prediabetes or diabetes doubled

• risk of overweight and obesity increased by 26%

• risk of prehypertension and hypertension increased by 22%

 

Regular postpartum blood glucose test with healthy lifestyle recommended

The above research results indicated that, in addition to the influences on mothers, GDM may also cause diabetes, cardiovascular disease or other chronic diseases in their offspring.  Prof. Wing Hung TAM, Professor, Department of Obstetrics and Gynaecology, Faculty of Medicine at CUHK, who led the study remarked, ‘All pregnant women should consider taking OGTT at 24 weeks to 28 weeks of pregnancy to screen for GDM.  They should also maintain healthy living habits and avoid excessive nutrients or sugar intake.  To minimize the long-term impact that GDM may bring to their offspring, pregnant women should adjust their eating and exercise regimen.  In certain cases, insulin injection may be necessary which would not affect the fetus.’

 

Prof. Ronald Ching Wan MA, Professor, Department of Medicine and Therapeutics, Faculty of Medicine at CUHK, added, ‘Although the postpartum blood glucose level of most women will return to normal, still some of them may eventually develop diabetes.  Therefore, women who have had GDM should have health checkups regularly, including checking blood glucose level every one to three years, and pay attention to changes in eating habits and weight.’

 

Prof. Albert Martin LI, Professor, Department of Paediatrics of the Faculty of Medicine at CUHK, said, ‘Obese children have a higher risk of developing cardiovascular disease or other chronic diseases.  We recommend to parents that they develop a healthy lifestyle with their children and mothers who had GDM should pay extra attention to avoid their children becoming overweight or obese.’

 

CUHK contributed to new GDM diagnostic criteria of WHO

The cohort statistics of the current research were drawn from HAPO, a large-scale international study that collected and analysed 25,000 pregnant women from 15 different regions all over the world from 2001 to 2006 to assess the impact of GDM.  The CUHK research team also took part in it.  Results of HAPO had a far-reaching impact on the definition of hyperglycaemia in pregnancy.  In 2010, the International Association of the Diabetes and Pregnancy Study Groups proposed a new diagnostic definition for gestational diabetes based on HAPO results, and the definition was adopted by the World Health Organization (WHO) (1) in 2013 and the Hong Kong College of Obstetricians and Gynaecologists (HKCOG) (2) in 2016. 

 

(1)WHO’s diagnostic criteria and classification of hyperglycaemia first detected in pregnancy:

http://www.who.int/diabetes/publications/Hyperglycaemia_In_Pregnancy/en/#

(2)HKCOG guidelines for the management of GDM

http://www.hkcog.org.hk/hkcog/Download/Guidelines_on_GDM.pdf

 

A recent study by CUHK Faculty of Medicine reveals that children born to mothers who suffered from gestational diabetes mellitus have higher risks of developing prediabetes or diabetes. (From left) Prof. Albert LI, Department of Paediatrics; Prof. Wing Hung TAM, Department of Obstetrics and Gynaecology; and Prof. Ronald Ching Wan MA, Department of Medicine and Therapeutics.

A recent study by CUHK Faculty of Medicine reveals that children born to mothers who suffered from gestational diabetes mellitus have higher risks of developing prediabetes or diabetes. (From left) Prof. Albert LI, Department of Paediatrics; Prof. Wing Hung TAM, Department of Obstetrics and Gynaecology; and Prof. Ronald Ching Wan MA, Department of Medicine and Therapeutics.

Madam LUI, whose mother is a diabetes patient, was diagnosed with GDM through oral glucose tolerance test in all three pregnancies. Her blood glucose level was under control after diet modification and her children are all healthy with normal weight.

Madam LUI, whose mother is a diabetes patient, was diagnosed with GDM through oral glucose tolerance test in all three pregnancies. Her blood glucose level was under control after diet modification and her children are all healthy with normal weight.

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Research
CUHK Advocates Atrial Fibrillation Screening and Drug Education to Reduce Risk of Stroke among Elderly

CUHK Advocates Atrial Fibrillation Screening and Drug Education to Reduce Risk of Stroke among Elderly

Clinical service
Screening Reveals Over 50% Community-dwelling Population Aged 65 or above are Pre-frail

Screening Reveals Over 50% Community-dwelling Population Aged 65 or above are Pre-frail

Research
CUHK Unveils Genome of Dermatophagoides farinae Casting New Light on Diagnosis and Interventions of Inhalant Allergies

CUHK Unveils Genome of Dermatophagoides farinae Casting New Light on Diagnosis and Interventions of Inhalant Allergies

Research
CUHK Reveals Vasopressin Injection Can Reduce Risks of Hysteroscopic Myomectomy

CUHK Reveals Vasopressin Injection Can Reduce Risks of Hysteroscopic Myomectomy

Research
Radiotherapy to Head and Neck Raises Risk for Stroke CUHK Proved Effectiveness of Carotid Angioplasty and Stenting

Radiotherapy to Head and Neck Raises Risk for Stroke CUHK Proved Effectiveness of Carotid Angioplasty and Stenting

Research
CUHK Research Reveals Young People with Normal Body Weight May Also Suffer from Diabetes Timely Treatment within 5-Year Golden Period may Help Prevent Complications

CUHK Research Reveals Young People with Normal Body Weight May Also Suffer from Diabetes Timely Treatment within 5-Year Golden Period may Help Prevent Complications

Research
CUHK Research Explains Why Patients with Cystic Fibrosis Often Develop Diabetes

CUHK Research Explains Why Patients with Cystic Fibrosis Often Develop Diabetes

Research
CUHK Research Shows 60% Diabetic Patients Have Poor Sleep Auriculotherapy Helps Improve Sleep Quality and Glycaemic Control

CUHK Research Shows 60% Diabetic Patients Have Poor Sleep Auriculotherapy Helps Improve Sleep Quality and Glycaemic Control

Research
CUHK Survey Reveals Majority of School Teens Have Insufficient Sleep

CUHK Survey Reveals Majority of School Teens Have Insufficient Sleep

Health Campaign
CUHK and PolyU Jointly Introduce TeleStroke for 24-hour Thrombolysis Service at Prince of Wales Hospital

CUHK and PolyU Jointly Introduce TeleStroke for 24-hour Thrombolysis Service at Prince of Wales Hospital

Clinical service
CUHK Releases Research Results on Employment Status of Hong Kong Chronic Kidney Disease (CKD) Dialysis Patients and Promotes Predialysis Education Programme for Mid to Late Stage CKD patients

CUHK Releases Research Results on Employment Status of Hong Kong Chronic Kidney Disease (CKD) Dialysis Patients and Promotes Predialysis Education Programme for Mid to Late Stage CKD patients

Research
CUHK Announces Latest Medical Treatment for Minor Stroke

CUHK Announces Latest Medical Treatment for Minor Stroke

Research
Hong Kong and Macau Among Top Three Regions in Asia-Pacific with the Highest Incidence of Inflammatory Bowel Disease CUHK Establishes Registry to Increase Public Awareness

Hong Kong and Macau Among Top Three Regions in Asia-Pacific with the Highest Incidence of Inflammatory Bowel Disease CUHK Establishes Registry to Increase Public Awareness

Research
CUHK and Joshua Hellmann Foundation for Orphan Disease Jointly Launch Territory’s First Newborn Metabolic Screening Program

CUHK and Joshua Hellmann Foundation for Orphan Disease Jointly Launch Territory’s First Newborn Metabolic Screening Program

Donation
CUHK-HCC Score Accurately Predicts Risk of Liver Cancer in Chronic Hepatitis B Patients Receiving Antiviral Therapy

CUHK-HCC Score Accurately Predicts Risk of Liver Cancer in Chronic Hepatitis B Patients Receiving Antiviral Therapy

Research
CUHK Introduces Hong Kong's First Fragile X Carrier Screening

CUHK Introduces Hong Kong's First Fragile X Carrier Screening

Clinical service
CUHK Pioneers the Use of 3D Echocardiography to Identify At-Risk Mitral Valve Prolapse Patients

CUHK Pioneers the Use of 3D Echocardiography to Identify At-Risk Mitral Valve Prolapse Patients

Research
CUHK Advocates Palliative Care for Advanced Dementia Patients with Swallowing Problems

CUHK Advocates Palliative Care for Advanced Dementia Patients with Swallowing Problems

Research
CUHK and US Experts Collaborate to Provide Clinical Genetic Training to Set up The Territory's First One-Stop Outpatient Genetic Clinic

CUHK and US Experts Collaborate to Provide Clinical Genetic Training to Set up The Territory's First One-Stop Outpatient Genetic Clinic

International collaboration
CUHK Develops an Automatic Retinal Image Analysis System to Help Diabetes Patients and Elderly Prevent Stroke

CUHK Develops an Automatic Retinal Image Analysis System to Help Diabetes Patients and Elderly Prevent Stroke

Research
CUHK Study Reveals High Salt Intake Will Lead to High Blood Pressure and Higher Risk of Stroke

CUHK Study Reveals High Salt Intake Will Lead to High Blood Pressure and Higher Risk of Stroke

Research
CUHK and HKU's Collaborative Research Discovers Novel Epilepsy Genetic Markers

CUHK and HKU's Collaborative Research Discovers Novel Epilepsy Genetic Markers

Research
CUHK Pioneers MRI Iron Assessment for Thalassemia Children in Southern China

CUHK Pioneers MRI Iron Assessment for Thalassemia Children in Southern China

Clinical service
CUHK Advocates Early Detection of Chronic Kidney Diseases Joined by Leading Nephrologists to Make Sound Recommendations

CUHK Advocates Early Detection of Chronic Kidney Diseases Joined by Leading Nephrologists to Make Sound Recommendations

Research
CUHK Discovers the Environmental Factors in Family and School Behind Constipation in HK Children

CUHK Discovers the Environmental Factors in Family and School Behind Constipation in HK Children

Research
CUHK Pioneers DNA Chip for Prenatal Diagnosis in HK

CUHK Pioneers DNA Chip for Prenatal Diagnosis in HK

Research
CUHK Proves the Potent Efficacy of Stenting for Carotid Artery Narrowing and Cardiac Contractility Modulation for Heart Failure

CUHK Proves the Potent Efficacy of Stenting for Carotid Artery Narrowing and Cardiac Contractility Modulation for Heart Failure

Research
Three CUHK Scholars Named Croucher Senior Research Fellow 2011-12

Three CUHK Scholars Named Croucher Senior Research Fellow 2011-12

Awards and honors
CUHK Research Findings on Severe Human Swine Flu in Hong Kong

CUHK Research Findings on Severe Human Swine Flu in Hong Kong

Research

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