Diabetes prevention begins in the womb

Nov 13 2015

60 million people worldwide are living with diabetes mellitus, and one in ten people over the age of 25 will develop the condition (type 2) at some stage in their lives. Globally, around 3.4 million people die from diabetes and its consequences every year. "Every six seconds, somebody somewhere in the world dies from diabetes", says Alexandra Kautzky-Willer from the Department of Endocrinology and Metabolism at the MedUni Vienna's University Department of Internal Medicine III. In the run-up to World Diabetes Day, she is pointing out that awareness of how to prevent the condition can and must begin at a very young age, and that early recognition of the signs and symptoms is vital.

95 per cent of children with diabetes diagnosed before the age of 15 have type 1 diabetes, in which the islet cells (beta cells) are destroyed by the body's immune system. This auto-immune disease causes destruction of the beta cells and an absolute deficiency of insulin. Says Kautzky: "Every year, there are between 200 and 300 new cases of the condition diagnosed in children under the age of 15. This number has doubled over the past ten years." The specific reasons for this have as yet not been researched, however a genetic predisposition is thought to play a role, as well as, more importantly, infections and environmental influences, and possibly even changes in intestinal flora.

If a child is very thirsty and constantly needs to urinate, loses a lot of weight and complaints of feeling tired, these are the first signs of a marked insulin deficiency. "This should prompt a blood glucose test as soon as possible or a visit to a specialist," advises the diabetes expert from the MedUni Vienna. "Severe and dangerous metabolic disorders can then be prevented. The earlier the condition is detected and treated, the more effectively complications can be avoided."

Type 2 diabetes: Prevention begins in the womb

Type 2 diabetes, on the other hand, develops slowly and gradually and could be prevented or at least delayed through a major change in lifestyle if pre-diabetes is detected early. This is the main form of diabetes diagnosed in adults. Being markedly overweight and having too much abdominal and liver fat, taking too little exercise, eating the wrong foods, stress and smoking are all risk factors. Even a reduction in weight of five per cent and a lower-fat diet avoiding trans-fats, animal fats and unhealthy carbohydrates, i.e. those that produce a rapid rise in blood sugar such as soft drinks, as well as taking more exercise, reducing stress and getting enough sleep, can have a preventative effect.

Prevention for babies, however, starts while they are still in the womb. Overweight pregnant women with a BMI of more than 29 in particular should undergo a glucose tolerance test earlier than prescribed in the pregnancy pack (between the 24th and 28th week of pregnancy) in order to diagnose and prevent gestational diabetes and the associated complications during pregnancy such as excessive, metabolically unfavourable weight gain and birth complications which can be so severe as to cause increased infant mortality. The test can also help prevent both the mother and the child from developing type 2 diabetes later in life.

A change of diet and losing weight really works

The EU DALI project, which draws to a close in December 2015 and in which Kautzky-Willer and a team from the MedUni Vienna played a key role, has shown that women who made major changes to their diets during early pregnancy gained less weight during the course of their pregnancy and had better blood glucose levels than mothers who only exercised but continued to consume unhealthy food. Says Kautzky: "The change of diet and weight loss therefore appear to work better in the pilot project than simple exercise, most likely too because these very overweight women are harder to motivate to make more exercise part of their daily routine during pregnancy. They are also more likely to be depressed than pregnant women of normal weight, which in turn is associated with less physical activity. The DALI project (Vitamin D and Lifestyle Intervention for Gestational Diabetes Mellitus Prevention) concludes on 10 December 2015 in Brussels with an international meeting at which more results will be presented (www.dalifp7.eventbrite.co.uk).

Around 600,000 people, which is around eight per cent of the population, are affected by type 2 diabetes in Austria.

Five research clusters at the MedUni Vienna

There are a total of five research clusters at the MedUni Vienna. The MedUni Vienna is increasingly focusing on fundamental and clinical research in these areas. The research clusters include medical imaging, cancer research / oncology, cardiovascular medicine, medical neurosciences and immunology. Research into diabetes falls under the remit of the cardiovascular medicine cluster.