Health Consequences For Mother And Baby Of Substantial Pre-conception Weight Loss In Obese Women
Funder
National Health and Medical Research Council
Funding Amount
$93,418.00
Summary
Obesity (BMI >30kg/m2) is now very common in women of child-bearing age.There is strong evidence that maternal obesity increases the rate of pregnancy complications, and affects the growth and well-being of the fetus in-utero. This project aims to determine how substantial pre-conception weight loss, achieved using a Very Low Energy Diet (VLED), impacts maternal and neonatal health outcomes.
Gestational diabetes (GDM) is a common complication of pregnancy with significant consequences. Early identification and lifestyle intervention can prevent GDM, but the best early screening test is unknown. Our primary aim is to validate our first trimester screening test for GDM in a large multi-ethnic cohort to accurately predict high-risk women and intervene early, preventing GDM onset and improving pregnancy outcomes, including long-term risk of obesity in the offspring.
In the last decade there has been a substantial increase in the number of overweight and obese individuals. Obesity is now a major public health issue in Australia and, along with its associated disorders of type 2 diabetes and heart disease, incurs significant health care costs. There is a widespread awareness of the problem, but it has proved difficult to bring this obesity epidemic under control, and unless we can understand the underlying causes, the trend seems set to continue. This researc ....In the last decade there has been a substantial increase in the number of overweight and obese individuals. Obesity is now a major public health issue in Australia and, along with its associated disorders of type 2 diabetes and heart disease, incurs significant health care costs. There is a widespread awareness of the problem, but it has proved difficult to bring this obesity epidemic under control, and unless we can understand the underlying causes, the trend seems set to continue. This research proposal seeks to define the mechanisms which lead to the development of obesity. Evidence from a large range of clinical and population-based studies has shown that infants who are exposed to an increased supply of nutrients before birth have an increased risk of being overweight or obese as children and adults. It is not however, fully understood why this occurs. In normal adults, factors released by fat cells play an important role in the maintenance of energy balance, and changes in the levels of these factors in the fat cell or in the circulation can lead to increased weight gain and the development of poor sensitivity of the body's tissues to the actions of hormones, such as insulin. Fat cells develop before birth, and therefore changes in nutrient supply to the fetus have the potential to alter the functional properties of fat cells for life. In this proposal, we will investigate the effect of being exposed to an increased supply of nutrients in fetal life on the properties of fat cells after birth and define how such changes explain the development of obesity in these individuals. Understanding the mechanisms which link the risk of obesity to events before birth will allow clinicians of the future to provide children who are born to overweight, glucose-intolerant or diabetic mothers with a healthy start to life.Read moreRead less
The Management Of Women With Type 1 Diabetes During Pregnancy And Breastfeeding.
Funder
National Health and Medical Research Council
Funding Amount
$50,741.00
Summary
Pregnancy in women with type 1 diabetes is associated with increased risks to the mother and baby and lower rates of breastfeeding. There is a relative paucity of published studies concerning the management of these women particularly in late pregnancy, immediately after delivery and during breastfeeding. Through a series of studies this project aims to address these areas of uncertainty and thereby improve the management of these women during these periods.
Improving Outcomes Of Diabetes And Related Conditions For Indigenous Australians: Causes, Intervention, System Change
Funder
National Health and Medical Research Council
Funding Amount
$274,218.00
Summary
My research program is focused on improving outcomes of diabetes and related conditions for Indigenous Australians through: (i) describing causal pathways; (ii) addressing health system change; and (iii) conducting clinical intervention studies.
The Treatment Of BOoking Gestational Diabetes Mellitus Study: The TOBOGM Study
Funder
National Health and Medical Research Council
Funding Amount
$2,197,280.00
Summary
Gestational diabetes mellitus (GDM) related pregnancy complications are reduced with treatment from 24-28 weeks pregnant. Many women are diagnosed/treated earlier without evidence of benefit and possible risk of harm. In TOBOGM women under 20 weeks pregnant with mildly raised blood glucose will be allocated by chance to either immediate treatment, or awaiting a repeat diabetes test at 24-28 weeks pregnant to decide treatment. Harmful and beneficial effects on mother and baby will be compared.
Birth Outcomes And Body Composition In Babies Born To Mothers With Diabetes In Pregnancy
Funder
National Health and Medical Research Council
Funding Amount
$109,358.00
Summary
This study will evaluate outcomes and body composition in neonates born to mothers who have diabetes during their pregnancy in the Northern Territory. Babies born to mothers with diabetes may be at higher risk of complications during birth and later in life may have increased risk of obesity and diabetes, conditions which are particularly prevalent in the Indigenous population and contribute to high morbidity and mortality rates. This study will be important to evaluate these factors, particular ....This study will evaluate outcomes and body composition in neonates born to mothers who have diabetes during their pregnancy in the Northern Territory. Babies born to mothers with diabetes may be at higher risk of complications during birth and later in life may have increased risk of obesity and diabetes, conditions which are particularly prevalent in the Indigenous population and contribute to high morbidity and mortality rates. This study will be important to evaluate these factors, particularly in a high risk population.Read moreRead less
Biochemical Basis Of Islet Beta-cell Compensation And Failure In Normal Pregnancy And Gestational Diabetes Mellitus
Funder
National Health and Medical Research Council
Funding Amount
$480,828.00
Summary
The factors causing the current world-wide crisis of rapidly rising diabetes prevalence remain poorly understood. Of potential major importance, however, is the hypothesis that abnormalities in the maternal metabolic environment, as occur in gestational diabetes (GDM) (diabetes that develops in pregnancy), result in abnormal development of metabolic systems in the baby resulting in higher risk of adult onset diabetes in the babies. Therefore, it is of importance to understand the mechanisms caus ....The factors causing the current world-wide crisis of rapidly rising diabetes prevalence remain poorly understood. Of potential major importance, however, is the hypothesis that abnormalities in the maternal metabolic environment, as occur in gestational diabetes (GDM) (diabetes that develops in pregnancy), result in abnormal development of metabolic systems in the baby resulting in higher risk of adult onset diabetes in the babies. Therefore, it is of importance to understand the mechanisms causing GDM, such that effective measures can be developed to counter this passing on of diabetes risk from mother to baby. It is known that a key factor causing GDM is failure of maternal pancreatic islet beta-cells to compensate for increased demands for insulin production in pregnancy. Poorly understood, however, are the cellular mechanisms of islet beta-cell compensation in normal pregnancy and failure of this compensation in GDM pregnancy. We have recently shown that there is a pathway of fat metabolism (triglyceride- free fatty acid cycle) within the islet beta-cell that has an important role in amplyfing insulin secretion necessary to maintain normal blood glucose and protecting the islets from failure in obese rats. The major focus of this project is to test the hypothesis that this pathway has a key role in the adaptation of pancreatic islets to normal pregnancy and its dysfunction contributes to the causation of GDM. Of great interest from preliminary findings is that a master regulator of glucose and fat metabolism, PGC1alpha, is markedly reduced in islets during normal pregnancy. Studies will also be directed to PGC1alpha's role in islet adaptation to pregnancy and failure in GDM. We expect that successful completion of this project will lead to the development of highly targeted counter measures to prevent GDM and to slow and reverse the current epidemic of diabetes.Read moreRead less