Children of those with diabetes are more likely to suffer from attention deficit disorder
The children of relatively poor parents with a form of diabetes are much more likely to suffer from attention deficit disorder (ADHD), according to a new study.
Researchers found youngsters exposed to maternal gestational diabetes mellitus and low socio-economic status, particularly in combination, appear to be at an increased risk of developing childhood ADHD.
Gestational diabetes mellitus (GDM) typically develops in the second and third trimesters and is defined as glucose intolerance with onset or first recognition during pregnancy.
Children exposed to maternal gestational diabetes mellitus and from a poor family, appear to be at an increased risk of developing childhood ADHD (picture posed by model)
The prevalence of GDM has been rising
for over 20 years, particularly among ethnic minorities and individuals
with low socio-economic status.
Other factors which heighten risk include lifestyle changes such as greater consumption of saturated fats, sugar, and
processed foods and sedentary working environments.
To examine the association of GDM and
low socio-economic status with neurodevelopment and ADHD outcomes,
Doctor Yoko Nomura, of Queens College, City University of New York, and
colleagues compared offspring of mothers with and without GDM in an
economically diverse sample.
The researchers distributed the ADHD Rating Scale-IV to parents of three and four-year-old children in preschools surrounding Queens College, and recruited 212 participants at a 2:1 ratio of 'at risk' to 'typically developing' children.
At-risk children had at least six inattention or six hyperactive and impulsive symptoms as rated by parents, teachers, or both.
'Typically developing' children had fewer than three symptoms in each domain.
The average inattention score for offspring exposed to mother's GDM was significantly higher than for offspring unexposed, but there was no difference in hyperactivity/impulsivity scores between the two groups.
Children from poor families, compared to wealthy families, had greater inattention and hyperactivity/impulsivity scores.
The results showed no difference in the risk for ADHD, but a two-fold increased risk at age six among children exposed to GDM compared with children who were not exposed.
Children exposed to both GDM and from poor families showed compromised neurobehavioural functioning, including a lower IQ (picture posed by model)
There was also a two-fold increased risk for ADHD at age six among children in low income families.
Children exposed to both GDM and from poor families showed compromised neurobehavioural functioning, including lower IQ, poorer language abilities and diminished behavioural and emotional functioning.
When examining the relationship of both GDM and poor background exposure, the researchers found a 14-fold increased risk of developing ADHD among children exposed to both GDM and low SES.
Conversely, children exposed to maternal GDM alone or low SES alone had no significant increased risk for ADHD.
Dr Nomura said: 'This study demonstrates that children of mothers with GDM raised in lower socio-economic households are at far greater risk for developing ADHD and showing signs of suboptimal neurocognitive and behavioural development.
'Since ADHD is a disorder with high heritability, efforts to prevent exposure to environmental risks through patient education may help to reduce the nongenetic modifiable risk for ADHD and other developmental problems.'
The findings were published online by the journal Archives of Pediatrics and Adolescent Medicine.
In an accompanying editorial, Doctor Joel Nigg, of Oregon Health and Science University, said: 'In the current issue of the Archives we see additional evidence, in a retrospective design, that early developmental events are related to subsequent ADHD in children.
'Most of the relevant environmental risks are presumed to occur very early in development.
'If causal, and if able to be understood pathophysiologically, such environmental effects on ADHD are of 'game-changing' importance because they open the door to eventually preventing that portion of cases of ADHD caused by early insult to the nervous system.
'If a specific environmental causal influence can be demonstrated, even if effective in a subset of children, and its biological mechanisms elucidated, then a powerful model will be created for how ADHD can develop.
'That discovery will be a crucial stepping-stone toward parsing multiple causal routes to what may be a final common pathway of the ADHD phenotype.'