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Inside the lab: Exploring the link between gestational diabetes and future risk of type 2

Every year we invest around £6.5 million into new diabetes research. This research helps us better understand diabetes and its complications, and how to transform treatments and lives. Here, we dive into one of our new projects exploring why having gestational diabetes can increase someone’s future risk of type 2 diabetes in later life.

Dr James Bowe is a Reader in Endocrinology and Diabetes at King’s College London. With our funding, he’s investigating how biological changes that happen when someone has gestational diabetes could influence their future risk of type 2 diabetes.

We asked him about his journey into diabetes research. He said:

My PhD was focused on the control of reproductive function in the brain, rather than diabetes research. During this time, researchers discovered that a hormone called kisspeptin plays an important role in stimulating puberty and adult reproduction. But kisspeptin also appeared to play an unidentified role in the pancreas and after my PhD I moved into diabetes research to investigate.

We found that kisspeptin plays a role in helping the pancreas cope with the demands of pregnancy. This has led to my current interest in pregnancy and gestational diabetes. This area is particularly fulfilling to me as it links my interest in diabetes research with my earlier focus on reproductive function.

Pregnancy and the pancreas

Gestational diabetes is a type of diabetes that can develop during pregnancy. It can cause complications during pregnancy and birth, as well as increase the future risk of type 2 diabetes in later life for both mother and baby.

Pregnant mums’ bodies change to allow sugar to move across the placenta and provide their baby with nutrients. As pregnancy progresses, the mum’s body can become less responsive to insulin, known as insulin resistance, so that more sugar is able available to the baby.

Usually, to make up for increased insulin resistance, insulin-producing beta cells in the mum’s pancreas will start to make more insulin so that their blood sugar levels remain in a healthy range. But in gestational diabetes this doesn’t happen properly. This is where Dr Bowe comes in.

With our funding, Dr Bowe is working out if this problem during pregnancy has a lasting impact on the pancreas and blood sugar control in mother and baby, and how this might put them at a greater risk of developing type 2 diabetes later on.

He’s found a way to study the biological process that leads to gestational diabetes by looking at mice who have beta cells that can’t adapt to pregnancy, so they develop high blood sugar levels.

He will identify how and why this happens by using a range of molecular biology techniques to find out how gestational diabetes can change the development and function of beta cells, and how this increases the chances of developing type 2 diabetes.

A new birth for gestational diabetes research

Dr Bowe’s research give us important insights that could lead to new treatments to help women and children of mums with gestational diabetes reduce their risk, and ensure fewer people will get type 2 diabetes in the future.

Dr Bowe also spoke about the kind of changes he’d like to see over the next decade for gestational diabetes care and research:

I’d like to see greater understanding and use of screening in early pregnancy to predict the risk of gestational diabetes.

Currently gestational diabetes is diagnosed once the condition has developed. A better understanding of why gestational diabetes occurs in different women will hopefully lead to improved diagnostic approaches to identify high-risk individuals. In turn this would allow us to intervene earlier and help improve outcomes for both mother and baby.

Outside of the lab

When he’s not in the lab, Dr Bowe doesn’t have a lot of spare time:

I have twin two-year-old girls, so don’t have as much time or energy for hobbies as I would like! However, I’m looking forward to getting back to running, trawling through record shops for old records and cooking new recipes to try out on my partner.

You can find out more about the research projects we fund. With their work, our researchers pave the way in transforming the lives of people with diabetes, but this wouldn’t be possible without the generosity of our wonderful supporters.

Dr Bowe said:

I would like to thank Diabetes UK for their continuing support of early-stage science in the lab. It’s sometimes more challenging to see how this research will directly lead to improvements in diabetes care. But a clearer understanding of how the pancreas functions during pregnancy and processes that lead to gestational diabetes will potentially have benefits in terms of identifying new treatments or improving care.

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