Wednesday, April 04, 2012

Babies treated in the womb for obesity: Overweight mothers-to-be get diabetes pill to cut the risk of having a fat child

Is this another DES disaster coming up?  Where are the long-term double-blind studies to support this policy?  Many molecules that are safe for adults  can be teratogenic.  Metformin works by suppressing glucose production by the liver.  Could it cause long term  liver damage  or malfunction in some of  the unborn?   That it has been safely used by diabetics is no guarantee that is will be equally safe in unborn babies.  We are looking at quite different metabolisms in the two cases

Babies are being medicated in the womb in an attempt to prevent them from being  born obese.   In a world first, dangerously overweight mothers-to-be in four British cities have started taking a diabetes drug during their pregnancy.

The doctors behind the controversial NHS trial say that obesity among pregnant women is reaching epidemic proportions and they need to act now to protect the health of tomorrow's children.

However, there is likely to be unease about resorting to medication in pregnancy for a problem that can be treated through changes in diet and exercise.

If the strategy is a success, the treatment could be in widespread use in as little as five years, with tens of thousands of overweight but otherwise healthy mothers-to-be drugged each year.

The Daily Mail recently revealed the rise of the 'sumo baby', with the number of newborns weighing more than 11lb soaring by 50 per cent over the last four years.

More than 15 per cent of pregnant women are obese. This raises their odds of dying in pregnancy, of their baby being stillborn and of a host of pregnancy complications, some of which can be fatal.

Big babies are around twice as likely to grow into overweight adults, suggesting obesity and the lifetime of ill-health it can bring is 'programmed' in the womb. The trial involves 400 pregnant women in Liverpool, Coventry, Sheffield and Edinburgh.

They have started taking metformin, which has been safely used by diabetics for decades and is cleared for the treatment of diabetes in pregnancy. It costs just pence per tablet.

Some of the participants have already had their babies but many more births will be needed before it is clear if the treatment works. Mothers-to-be elsewhere are due to take part.

The study aims to exploit the ability of metformin to lower levels of the hormone insulin in the bloodstream.

Obese women make more insulin than other mothers-to-be and this leads to a greater nutrition supply reaching the baby.

It is hoped that lowering levels of insulin will reduce the supply and so cut the odds of babies being born obese.

Treatment with metformin may redistribute the baby's fat stores, reducing the deposits around the liver and other organs.

Study leader Professor Jane Norman of Edinburgh University said: 'One of the challenges is that many women feel perfectly healthy but there is very good evidence that women who are obese have an increased risk of pregnancy problems and their babies are at risk, and we'd like to reduce that risk.'

Addressing concerns about unborn babies being medicated for a problem that many would say could be treated by diet and exercise, she said: 'I absolutely support the improvement of diet and encouraging exercise.

'But we are increasingly faced with women who start their pregnancy obese. Saying at that stage to eat less and exercise more is not particularly helpful.'

Obesity experts have welcomed the study, which is funded by the Medical Research Council, the NHS's health research arm and the baby charity Tommy's, saying that while the situation is not ideal, it needs to be tackled.

Patrick O'Brien of the Royal College of Obstetricians and Gynaecologists described the study as 'very important'.  He said: 'When you are overweight in pregnancy you are at increased risk of just about every complication you can think of.'


Britain's obesity madness again

Stories like this pop up often  -- showing how mindless the definition of obesity has become.  It's child abuse

She dreams of becoming a  ballerina and when she’s not dancing, four-year-old Sophie Kettle spends her free time swimming, roller-skating and riding her bike.  So her parents were astounded to receive a letter from the NHS saying their daughter, who weighs just 2st 13lb, is ‘overweight’.

The medical note warned that Sophie is in the fattest 3 per cent of her age group and is at increased risk of heart disease, cancer and diabetes.  The 3ft 3in youngster was taken to the family GP, who informed her she was ‘obese’ and in the ‘danger zone’.

Her mother Joanna said that Sophie, who had been happy and healthy, now often refuses her food.  Herself a former anorexic, Mrs Kettle fears her daughter could eventually develop an eating disorder.

‘She comes home from school saying, “Mummy, I’m fat”, and I have to explain to her that she’s just perfect as she is,’ said Mrs Kettle, 29, from High Wycombe, Buckinghamshire.  ‘It’s terrible that a child so young should be worrying what she eats.’

Sophie and her classmates at Hamilton primary school in High Wycombe had their height and weight measured by NHS staff to calculate their body mass index (BMI) as part of the National Child Measurement Programme, which aims to pinpoint youngsters with weight problems.

For adults, BMI is measured by dividing weight in kilograms by height in metres squared.

Although the calculation for children begins the same way, the result is then compared with those of others of the same age and sex to calculate the child’s ‘centile’ – or position relative to others on a scale of one to 100.

The letter to Mrs Kettle and her husband James, a traffic warden, said their daughter has a BMI ‘centile’ of 97 – meaning she is in the top 3 per cent. Between 91 and 97 is classed as overweight while 98 and above is clinically obese.

‘If she was a teenager and overweight, I would be the first to be concerned,’ said Mrs Kettle. ‘But she’s not even five and she’s a tiny little thing without an ounce of fat on her.

‘The GP told me to give Sophie smaller portions, but she’s being given healthy food, not biscuits and crisps.’

In her school packed lunch, Sophie takes two or three pieces of fruit, and her mother says there are always vegetables with dinner.

‘She’s such an active child,’ she added. ‘Her dream is to become a ballet dancer and she’s on a waiting list for lessons.’

Mrs Kettle, who also has a two-year-old son, Ryan, is concerned her daughter might struggle with the same food issues she herself faced as a teenager.  She said: ‘I ended up damaging my body, and I would hate for Sophie to do the same.’

Susan Ringwood, chief executive of the eating disorder charity BEAT, said: ‘It is important that any health-related information is given very sensitively.  ‘BMI alone is a very unreliable measure of overall health especially where children are concerned as they are still growing taller.  ‘Raising a child’s insecurities about weight and shape can lead to problems in the future.’


1 comment:

John A said...

" the [BMI] result is then compared with those of others of the same age and sex to calculate the child’s ‘centile’ – or position relative to others on a scale of one to 100."

Um, so does that mean 30-thousand suburban/rural kids who lead active lives are measured the same as 1-million 'don't you dare go outside" city couch potatoes? And how can a FP look at that child and say she is onese-bordering-on-mornidly-so?