Issues persist even when drug treatments for gestational diabetes are given, U of A study shows.

Pregnant women diagnosed with diabetes who have elevated fasting (pre-meal) blood sugar levels are more likely to face complications than those who have only elevated post-meal glucose levels, according to a new study by a University of Alberta research team.

“The women who had elevated fasting glucose, adjusted for all other risk factors, were almost three times more likely to have a big baby than women who had normal fasting glucose levels but elevated postprandial sugar levels,” said cardiology professor Padma Kaul, who is also an adjunct professor in the School of Public Health.

The women with high fasting blood sugars were also found to be at 1.5 times higher risk for high blood pressure during pregnancy, and had a higher likelihood of needing an induced labour, having a caesarean section or having a preterm birth.

Kaul said large babies are at risk for complications during birth and obesity later in life, and high blood pressure during pregnancy can place extra stress on the heart and kidneys of a mother.

The researchers found that the adverse outcomes for women with high fasting blood sugars persisted even when the women were given diabetes drug treatments such as insulin or metformin.

“Why the women who have fasting glucose are less responsive to treatment is a very important question,” Kaul said. “It may indicate some other mechanism that requires further study.”

Kaul said further research is needed to determine whether earlier or more aggressive diabetes treatment for women with high fasting glucose levels would reduce or prevent the adverse outcomes. 

The researchers examined health records for more than 250,000 pregnancies in Alberta between 2008 and 2014. Nearly 13,000 of the mothers were diagnosed with gestational diabetes. Four thousand had elevated fasting blood sugars of 5.3 mmol/L or higher, whereas the others had normal blood sugars while fasting but showed elevated levels following an oral glucose tolerance test. 

Kaul explained that nearly all pregnant women in Alberta undergo a two-step screening process for gestational diabetes. The first test, done between 20 and 24 weeks of gestation, is a 50 gram oral glucose tolerance test, taken at any time of the day. If the woman’s blood sugar is found to be higher than 7.8 mmol/L one hour later, she is sent for the second test, which involves giving a blood sample after 12 hours of fasting, usually first thing in the morning, then ingesting 75 grams of glucose and giving more samples one and two hours later. 

Kaul said that about 15 per cent of pregnant women in Alberta receive the second test and about one-third of those tested are diagnosed with gestational diabetes. As trends in older maternal age and higher weight in pregnancy continue, rates of gestational diabetes are also on the rise.

The study was conducted at the Canadian VIGOUR Centre, where Kaul is co-director, and was funded by the Canadian Institutes of Health Research.

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New York: Parents, please take note. Researchers have revealed that less active infants may accumulate more fat, which in turn may put them at risk for obesity later in life.

For the study, published in the journal Obesity, researchers tracked the physical activity levels of 506 infants using small ankle-worn accelerometers for four days per tracking period at ages 3, 6, 9, and 12 months.

For each tracking period after 3, average physical activity increased by about four per cent, in line with infants becoming generally more mobile and active over the course of their first year.

Among infants, higher physical activity measured by the accelerometer was associated with lower central adiposity, a measure of lower-torso fat accumulation, the study said.

“This is the first study to demonstrate an association over time between higher levels of objectively measured physical activity and lower central adiposity in infancy,” said study lead author Sara Benjamin-Neelon from Johns Hopkins University in US.

The study was part of a larger study of infant growth and obesity, called the Nurture study, which covered 666 mothers and their infants from the greater Durham, North Carolina, area during 2013 to 2016.

Of this group, the research team were able to get adequate accelerometer data for 506 infants.

“Some evidence suggests that the earlier you can get infants crawling and walking, and providing them with opportunities to move freely throughout the day, the more you can help protect them against later obesity,” Benjamin-Neelon said.

The study found that among the infants in the study, an increase in recorded activity by one “standard deviation”–essentially a standard proportion of the range of the data–was associated with a small but significant decrease in central adiposity.

The researcher noted that larger, longer-term studies will be necessary to determine the sustained effect of infant physical activity, but that preventing extended periods of inactivity for infants will almost certainly be good for them.

“These days, infants are spending more and more sedentary time in car seats, high chairs, strollers–and perhaps we haven’t thought enough about the developmental ramifications of these types of restrictive devices,” Benjamin-Neelon concluded.

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LOS ANGELES (CBS)  — A bill requiring hearing aids for babies and young children is one step closer to passage.

The bill cleared the state assembly and is now headed to the California senate.

CBS2/KCAL9’s Randy Paige spoke to one family at a hearing clinic about the impact of the vote.

He listens to a 5-year-old girl as she gushes about one of her favorite things — ice cream!

“I like vanilla and chocolate but do you know this kind of ice cream…,” says Zoe.

You’re witnessing a miracle and it’s made possible by the tiny piece of technology tucked inside the little girl’s ear — a hearing aid.

When Zoe was diagnosed with a severe hearing loss as a baby, it was a race against time to get her fitted for hearing aids. With each passing day, her brain was missing out on critical auditory clues about the world around her.

She was unable to hear the frequencies of her own mother’s voice.

“When you have an infant and you have all these aspirations for them, Rhodes scholar, or whatever, and you don’t even know if they’re going to be able to talk it’s just so painful,” says Zoe’s mom.

“The first sIx months are critical so that the brain can start making sense of what all these sounds are and what it means,” says Cathleen Mathes, president and CEO of the John Tracy Center, a nationally recognized clinic for families with children who are deaf or hard of hearing.

Mathes was also Zoe’s therapist.

Paige asks what would have happened if Zoe hadn’t received her hearing aids early on.

“It would be very difficult for her to gain spoken language skills,” says Mathes, who acknowledges without the early intervention Zoe would be unable to speak in long, full sentences, “the way we heard her speak today,” she says.

Zoe’s mom says she had to borrow used hearing aids from the Tracy Clinic — at first — and it was a financial struggle to come up with the $8,000 she needed to buy Zoe’s aids a short time later.

” I saw my bank account go from positive to  negative pretty fast,” she says.

That’s because health insurance companies in California are not required to cover the cost of hearing aids in children.

It’s estimated that only one in 10 families have private insurance that has a policy that covers hearing aids.

That could soon change. A parent-led initiative has now passed the state assembly and headed to the California senate.

If AB598 is passed into law, it would require health insurance companies to include coverage for children’s hearing aids.

“I actually think about the light coming through the window and the dust settling in the room,” says Zoe’s mom

She looks at a photo — taken on the day Zoe first heard her mother’s voice.

“From about 10 feet away, when they turned on her hearing aids I called her name and she lit up. And I knew that she was on. So I said Zoe, and she turned around and she looked at me and smiled and I just knew that we were connected and I was, I just I can’t tell you how excited I was to see her and know that we were going to be okay.”

And now nearly five years later, Zoe carries the promise of all of the other children who need the key to unlock the sounds of the outside world — but many may not be able to afford it.

Backers of the bill are optimistic about the future. They say if it sails through the senate, Govenor Newsom has shown that he cares about the needs of young children.

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