Research Summary

Hyperglycemia in Pregnancy and risk of chronic diseases in children- Establishing a Birth Cohort in Bangalore, India.

Modification in the parenteral milieu can have adverse effects on infants and subsequent development of diseases. High glucose levels in pregnancy can increase the risk of adiposity and Type 2 Diabetes Mellitus (T2DM) in children. In addition, compensatory adaptive changes such as storing excess energy as fat may occur subsequent to confrontation with undernutrition as a fetus and child. Irrespective of the mechanism, the severity and form of changed intrauterine environment may have distinct role in the development of childhood obesity and T2DM in adult life. 
 
The impact of lesser degrees of glucose intolerance in Indian mothers on child outcomes is yet to be adequately understood. The objective of our research is to study the effect of any degree of glucose levels in pregnant women on skinfold thickness (adiposity) and other early markers of Non Communicable Diseases (NCDs) in childhood. We piloted the feasibility of setting up the birth cohort in public health facilities in Bangalore, enrolling more than 900 pregnant women. Currently, we are expanding the birth cohort to multiple centres and plan to store specimens for identifying early markers for NCD’s. The research aims to harness life course perspectives on development of NCDS and contribute towards early prevention.
 
Figure Legend: The figure describes potential mechanisms of development of Type 2 Diabetes Mellitus (T2DM). The ‘fuel-mediated teratogenesis’ hypothesis identifies deleterious effects of high intrauterine glucose on child outcomes. The ‘thrifty phenotype’ hypothesis represents adaptive mechanisms due to child undernutrition result in T2DM epidemic. Increasing urbanization and ensuing lifestyle modifications also contribute to predisposition of T2DM at an early age.