Pregnant women invited to take part in pioneering diabetes prevention research

NIHR |July 2018 | Pregnant women invited to take part in pioneering diabetes prevention research

Pregnant women visiting maternity clinics in Berkshire, Buckinghamshire, Milton Keynes and Oxfordshire are being invited to participate in a new study, The INvestigating Genetic Risk for type 1 Diabetes (INGR1D), to identify the risk of their child developing type 1 diabetes.

Mothers of infants identified to have a higher risk of type 1 diabetes will then be offered an opportunity to take part in the Primary Oral Insulin Trial (POInT trial) to see if giving  high-risk children small doses of insulin powder can prevent them from developing type 1 diabetes.

Participants on the trial are given the powder or a placebo, to compare the two. Parents are asked to give their children insulin powder daily until they are three years old. They will have visits from the research team to monitor the child’s health.

The scientists hope that this intervention can train the immune system to tolerate the body’s own insulin to prevent the onset of type 1 diabetes (Source: NIHR).

Full details are available from NIHR 

In the news:

BBC News Stopping type 1 diabetes from birth

Takeaways linked to increased cardiovascular risk factors and obesity in children

Donin AS, Nightingale CM, Owen CG, et al. Takeaway meal consumption and risk markers for coronary heart disease, type 2 diabetes and obesity in children aged 9-10 years: a cross-sectional study. Arch Dis Child. 2017

Children who eat takeaways once or more each week have more body fat and higher low-density lipoprotein (LDL) “bad” cholesterol levels than those who never or hardly evefish-and-chipsr eat them. Their diets were also higher in fat and lower in protein and calcium.

This cross-sectional study looked in depth at eating habits and risk markers for coronary heart disease, obesity and diabetes in 2,529 children in England. Though this type of study can only show an association between takeaways and risk markers, it is one of the first of its type, and the results do give cause for concern.

Increasing numbers of people are eating takeaways in the UK. Local authorities and healthcare professionals are well placed to encourage parents and children to choose healthier foods, in line with current national guidance.

Is it safe to express milk before giving birth?

Some women, especially with diabetes, are recommended to express milk while still pregnant and to save it for their newborn, yet no evidence exists for this practice.

A study published in today’s Lancet aimed to determine the safety and efficacy of antenatal expressing in women with diabetes in pregnancy.

pregnancy-466129_1920 The study found that expressing while pregnant is safe for women with diabetes in low-risk pregnancies in late pregnancy (from around 36 weeks). After studying over 600 women, the authors found no increase in early births or admissions to neonatal intensive care. However, one in four women couldn’t collect any colostrum.

Before the trial, researchers had only run three small studies of expressing colostrum while pregnant, and no randomised trials for women without diabetes.

The authors advice to women with questions about expressing while pregnant is to ask their health care professional about their individual situation.

Read more at The Conversation

Full reference: Forster, Della A et al. | Advising women with diabetes in pregnancy to express breastmilk in late pregnancy (Diabetes and Antenatal Milk Expressing [DAME]): a multicentre, unblinded, randomised controlled trial | The Lancet , Volume 389 , Issue 10085 , 2204 – 2213

A Structured Transition Program Among Young Adults With Type 1 Diabetes

Pyatak, E. et al. Journal of Adolescent Health. Published online: November 23 2016


Purpose: We identified and treated young adults with type 1 diabetes who had been lost to follow-up during their transfer from pediatric to adult care, comparing their clinical, psychosocial, and health care utilization outcomes to participants receiving continuous care (CC) throughout the transition to adult care.


Conclusions: Our study suggests that, for young adults with a history of lapses in care, a structured transition program is effective in lowering A1C, reducing severe hypoglycemia and emergency department utilization, and improving uptake of routine diabetes care. Loss to follow-up and psychosocial concerns remain significant challenges in this population.

Read the full abstract here

I Should but I Can’t: Controlled Motivation and Self-Efficacy Are Related to Disordered Eating Behaviors in Adolescents With Type 1 Diabetes

Eisenberg, M.H. Journal of Adolescent Health. Published online: August 2016


Purpose: Among adolescents with type 1 diabetes, disordered eating behaviors (DEBs) are more prevalent and have more serious health implications than in adolescents without diabetes, necessitating identification of modifiable correlates of DEB in this population. This study hypothesized that (1) autonomous motivation and (2) controlled motivation for healthy eating (i.e., eating healthfully because it is important to oneself vs. important to others, respectively) are associated with DEB among adolescents with type 1 diabetes. The third hypothesis was that baseline healthy eating self-efficacy moderates these associations.

Methods: Adolescents with type 1 diabetes (n = 90; 13–16 years) participating in a behavioral nutrition intervention efficacy trial reported DEB, controlled and autonomous motivation, and self-efficacy at baseline, 6, 12, and 18 months. Linear-mixed models estimated associations of controlled and autonomous motivation with DEB, adjusting for treatment group, body mass index, socioeconomic status, age, and gender. Separate models investigated the interaction of self-efficacy with each motivation type.

Results: Controlled motivation was positively associated with DEB (B = 2.18 ± .33, p < .001); the association was stronger for those with lower self-efficacy (B = 3.33 ± .55, p < .001) than those with higher self-efficacy (B = 1.36 ± .36, p < .001). Autonomous motivation was not associated with DEB (B = −.70 ± .43, p = .11).

Conclusions: Findings identify controlled motivation for healthy eating as a novel correlate of DEB among adolescents with type 1 diabetes and show that self-efficacy can modify this association. Motivation and self-efficacy for healthy eating represent potential intervention targets to reduce DEB in adolescents with type 1 diabetes.

Read the abstract here

Archives of Disease in Childhood: March 2016, Volume 101, Issue 3

adc cover
Image source: ADC

Highlights from the March issue include:

  • Female genital mutilation: see pages 212, 267 and 207.
  • The legal basis for compulsorily detaining children and young people for treatment: see page 210.
  • Families priorities in life limiting illness: see page 247.
  • Coeliac screening in type 1 diabetes: see page 230.
  • Management of speech and language disorders: see pages 272 and 278.

View the full ‘Highlights from this issue’ by
R Mark Beattie here

Below: Mark Beattie discusses the March 2016 Atoms section of the journal, highlighting the most interesting papers from the issue.


Read the issue here