Women who have diabetes before or during pregnancy are at a higher risk of having children who go on to have eye problems, new research has shown.

The large-scale study found that exposure to maternal diabetes was linked to a 39 per cent greater risk that a child would go on to develop high refractive error (RE), one of the most common causes of eyesight problems such as long and short-sightedness.

While glasses and contact lenses can help to correct low-degree RE, high-degree RE can develop into more severe sight problems which cannot be reversed.

Researchers, led by Dr Jiangbo Du from State Key Laboratory of Reproductive Medicine at Nanjing Medical University, China, and Dr Jiong Li, from Aarhus University in Denmark, said:
“In this nationwide population-based cohort study, we observed that children born to mothers with either pre-gestational or gestational diabetes were at an increased risk of developing high RE in general, as well as specific types of high RE, persisting from the neonatal period to early adulthood. Children born to mothers with diabetic complications had the highest risk of high RE.

“As many REs in young children are treatable, early identification and intervention can have a lifelong positive impact. Although the 39% increased risk is a relatively low effect size, from a public health perspective, considering the high global prevalence of REs, any tiny improvement in this low-risk preventable factor will contribute to a huge reduction in absolute numbers of these eye conditions.”

Over the last few decades there has been an increase in RE prevalence, suggesting that non-genetic factors may be having an impact. Close-up work including using a computer for long periods of time, along with less outdoor activity, has been associated with low and moderate RE development in young adults and school-age children.

Researchers believe maternal diabetes can negatively affect the development of a fetus, increasing the risk of developing high RE in later life. The high blood sugar during pregnancy could lead to raised fetal blood glucose levels, which can damage the retina and optic nerve and change the shape of the eyes, causing RE in the long term.

The study used data from a number of Danish medical registers and looked at all live births in Denmark from 1977 to 2016. Out of almost 2.5 million births, 56,419 (2.3%) were exposed to maternal diabetes – 0.9% and 0.3% being type 1 and type 2, pre-gestational diabetes respectively and 1.1% involving gestational diabetes.

The difference in risk of developing high RE between type 1 and type 2 diabetes was found to be 32% and 68% higher respectively.

Researchers also noted an increase in the number of births to mothers with diabetes during the period of the study – the figures rose from 0.4% in 1977 to 6.5% in 2016.
The team recommended early screening for eye problems in children whose mothers had diabetes.

The study has been published in Diabetologia, the journal of the European Association for the Study of Diabetes.

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