Posted on Autism, Infectious Diseases

Pandemic-era babies do not have higher autism risk

Researchers from Columbia University Vagelos College of Physicians and Surgeons found that children born during the first year of the pandemic, including those exposed to COVID in utero, were not more likely to screen positive for autism compared to unexposed or pre-pandemic children.

“Autism risk is known to increase with virtually any kind of insult to a mother during pregnancy, including infection and stress,” says Dani Dumitriu, associate professor of paediatrics and psychiatry and senior author of the study. “The scale of the COVID pandemic had paediatricians, researchers, and developmental scientists worried that we would see an uptick in autism rates. But reassuringly, we didn’t find any indication of such an increase in our study.”

“It is important to note,” Dumitriu adds, “that the study did not examine autism diagnosis but rather the risk of developing autism as indicated by a screening questionnaire completed by the child’s parents. “It’s too early to have definitive diagnostic numbers,” she says. “However, this screening tool is predictive, and it does not indicate that prenatal exposure to COVID or the pandemic increases the likelihood of autism.”

“There has been widespread speculation about how the COVID generation is developing, and this study gives us the first hint of an answer regarding autism risk.”

Investigating autism risk and COVID 

Dumitriu’s team has been researching the possible impact of COVID-19-related maternal stress and maternal infection on child neurodevelopment at various stages from birth through the COMBO (COVID-19 Mother Baby Outcomes) Initiative. Children who were in the womb during the initial phases of the pandemic are now approaching the age when early signs of autism risk may become apparent.

The recent study looked at almost 2,000 children born at NewYork-Presbyterian’s Morgan Stanley Children’s Hospital and Allen Hospital from January 2018 to September 2021. The study assessed the risk of autism based on the responses from a neurodevelopment screening questionnaire that paediatricians give to parents to evaluate toddlers’ behaviour. The scores were compared for children born during and before the pandemic and children with and without in-utero exposure to COVID. All the children were screened between 16 and 30 months of age.

Reassuring results 

The researchers found no difference in positive autism screenings between children born before the pandemic and those born during the pandemic.

“COVID is still quite prevalent, so this is comforting news for pregnant individuals who are worried about getting sick and the potential impact on autism risk,” Dumitriu says.

Surprisingly, the study also found that fewer children exposed to COVID in utero screened positive for autism compared with children whose moms did not have COVID.

“We suspect that experiencing COVID during pregnancy may have affected how parents evaluated their child’s behaviours,” Dumitriu explains. “Parents who did not have COVID may have experienced higher stress due to constant worry about getting sick and being vigilant about preventing infection. This might have made them more likely to report concerning child behaviours.”

Could autism show up later in childhood?  

As the children age, the researchers will continue to monitor them for autism diagnoses. But based on the current results, Dumitriu thinks it unlikely that an uptick in autism related to COVID will occur.

“Children who were in the womb early in the pandemic are now reaching the age when early indicators of autism would emerge, and we’re not seeing them in this study,” Dumitriu says. “And because it’s well-known that the prenatal environment influences autism, this is highly reassuring.”

However, other impairments may emerge later, and the researchers will continue to study the children’s neurodevelopment as they age.

Several studies of infants who were in utero during previous pandemics, natural disasters, famines, and wartime have shown that other neurodevelopmental conditions, potentially triggered by the stressful environment, can emerge in adolescence and even early adulthood. 

“We need to recognize the distinct experiences and environment of children born during the pandemic, including parental stress and social isolation. We should continue to monitor them for potential developmental or psychiatric differences,” said Morgan Firestein, the study’s first author and an associate research scientist in psychiatry.

Posted on Diabetes

Widely used test for gestational diabetes misses 70% of cases

When screening pregnant women for gestational diabetes, casual blood glucose testing misses 70% of the cases. This Kobe University study should encourage obstetricians to depend on more reliable tests to help prevent pregnancy complications and the development of type II diabetes in mothers and children.
When screening pregnant women for gestational diabetes, casual blood glucose testing misses 70% of the cases. This study from Kobe University should encourage obstetricians to rely on more reliable tests to help prevent pregnancy complications and the development of type II diabetes in mothers and children.

Gestational diabetes mellitus is a condition in which previously healthy women experience high blood sugar levels during pregnancy. When treated, most women deliver healthy babies. However, if left unmanaged, it can lead to pregnancy complications, larger-than-usual babies, and an increased risk of developing type II diabetes later for both the mother and the child. To address this, the International Association of the Diabetes and Pregnancy Study Groups recommends that all women who have not been previously diagnosed with diabetes undergo an oral glucose tolerance test between weeks 24 and 28 of pregnancy. This multi-step procedure involves fasting for 8-12 hours, taking a baseline blood sample, consuming a standardized glucose solution, and using another blood sample to assess sugar metabolism. However, many health facilities use a simpler “casual” blood glucose test, which is cheaper and quicker. This test involves analyzing blood glucose levels at any time, without considering the woman’s recent food intake. Only if women test positive in the simple screening are they asked to undergo the more rigorous glucose tolerance test.

The obstetrician Tanimura Kenji and his graduate student Tomimoto Masako from Kobe University were worried that the current two-tier approach might be overlooking cases of diabetes during the initial screening. They conducted a study at the perinatal centre of Kobe University Hospital where they combined the casual blood glucose screening with a more sensitive glucose challenge test into a single protocol for all women visiting their centre. They then asked women who tested positive in the glucose challenge test to also take the glucose tolerance test, in order to determine how many positive cases would have been missed if they had relied only on the casual blood glucose screening.

The study, published in the Journal of Diabetes Investigation, found that out of 99 women diagnosed with gestational diabetes mellitus, 71.7% had blood sugar levels in their first blood sample, which would have led to a negative (no diabetes) diagnosis. Tomimoto explained, “Although previous studies have shown that the casual blood glucose test is less sensitive than others, no studies have directly compared the results in the same individuals. Our study confirmed that this screening method, widely used in practice, often fails to detect the condition it is meant to identify.”

Posted on Children's health, Diabetes

New blood test could be an early warning for child diabetes

Antiphospholipid syndrome
Antiphospholipid syndrome

A new type of blood test using lipids could make it easier to identify children at risk of complications around obesity, including type two diabetes, liver and heart disease, say scientists.

A new study from King’s College London, published in Nature Medicine, reveals a new relationship between lipids and diseases impacting metabolism in children. This relationship could serve as an early warning system for conditions like liver disease.

The researchers suggest using machines that test blood plasma in babies already in hospitals to help doctors spot early signs of disease in children quicker and help them access the right treatment.

The findings also contest the common idea that cholesterol is a leading cause of complications related to obesity in children, identifying new lipid molecules that contribute to health risks like blood pressure but are not only correlated with a child’s weight.

Lipids have traditionally been considered fatty acids in the body, either good or bad types of cholesterol or triglycerides, fats found in the bloodstream that is the most common in the human body. Recent studies from the same scientists have suggested that the picture is more complex.

Current evidence, using a technique associated with chemistry called mass spectrometry, estimates the thousands of different lipids present in the body, each with a separate function.

The team took a control sample of 1,300 children with obesity and assessed their blood lipids. Afterwards, 200 of them were put on the HOLBAEK model for a year, a lifestyle intervention popular in Denmark for people with obesity.

Subsequent readings showed that among the intervention group, lipid counts tied to diabetes risk, insulin resistance, and blood pressure decreased despite limited improvements in some children’s BMI.

Dr Cristina Legido-Quigley, a group leader in Systems Medicine at King’s College London, Head of Systems Medicine at the Steno Diabetes Centre Copenhagen (SDCC) and principal author, said: “For decades, scientists have relied on a classification system for lipids that have split them into good and bad cholesterol, but now with a simple blood test we can assess a much broader range of lipid molecules that could serve as vital early warning signs for illness. In the future, this has the potential to be an entirely new way to evaluate someone’s risk of disease, and by studying how to change lipid molecules in the body, we could even prevent metabolic diseases like diabetes altogether.”

Obesity continues to be a risk factor for conditions like fatty liver disease, but the team hope that doctors can use these measurements to treat children when they are at risk and not just a little larger than their peers.

Dr Karolina Sulek, who participated in the study and performed analysis at the SDCC, said: “Early recognition of children at risk for these life-threatening diseases is crucial. The study provides strong evidence of the great need for obesity management and gives parents confidence to intervene more compassionately in their children’s lives, helping them to lose weight.”

Posted on Diabetes, Obesity

Impact of weight loss and blood sugar control in T2 Diabetes

Study finds that type 2 diabetes patients treated with GLP-1RAs who lowered their BMI also reduced their cardiovascular risk
Study finds that patients with type 2 diabetes treated with GLP-1RAs who reduced their BMI also lowered their cardiovascular risk.

A research team from the Cleveland Clinic has recently conducted the first study evaluating the separate real-world effects of weight loss and blood sugar control on clinical outcomes in individuals with type 2 diabetes who are being treated with antidiabetic medications, specifically GLP-1RAs, which includes drugs like Ozempic and Wegovy.

The study discovered that for every 1% decrease in BMI, there was a 4% decrease in cardiovascular risk, irrespective of changes in blood sugar levels. Additionally, effective control of blood sugar, regardless of weight change, was associated with a reduced risk of chronic kidney disease. These findings are significant from a clinical standpoint and underscore the importance of addressing both glycemic control and obesity in individuals with type 2 diabetes.

The retrospective findings, which were published in Diabetes, Obesity, and Metabolism, used de-identified electronic health record-derived data from over 1,300 patients with type 2 diabetes who were evaluated at Cleveland Clinic.

Posted on Dental health, Diabetes

Intensive diabetes treatment reduces gum disease inflammation

A research group at Osaka University revealed that intensive treatment for diabetes can improve the inflammatory state of periodontal disease.
A research group at Osaka University discovered that intensive diabetes treatment can improve the inflammatory state of periodontal disease.

Recent research published in Diabetes, Obesity, and Metabolism has shown that intensive diabetes treatment can positively impact periodontal health. This demonstrates that periodontal inflammation can be improved through intensive diabetes treatment despite the known link between diabetes and periodontal disease.

It is widely believed that diabetes and periodontal disease are interrelated. While it has been shown that treating periodontal disease improves blood glucose control, the effect of diabetes treatment on periodontal disease has remained largely unknown.

A collaborative research team from Osaka University conducted a two-week intensive diabetes treatment study with 29 type 2 diabetes patients. The results showed improvements in blood sugar control and periodontal health indicators. Patients who showed significant periodontal improvement also had higher pre-treatment C-peptide levels, suggesting better insulin secretion and less severe diabetic neuropathy and peripheral vascular disorders.

“These research findings are expected to advance our understanding of the relationship between diabetes and periodontal disease,” says senior author Masae Kuboniwa. “Improving periodontal disease in diabetic patients requires both periodontal treatment and early diabetes management. Promoting collaboration between medical and dental care from the early stages of diabetes can significantly prevent the onset and progression of periodontal disease in diabetic patients.”