In a study conducted by the Yale School of Public Health (YSPH), researchers are looking at gestational diabetes among pregnant women in American Samoa, which has unusually high risks for developing the condition.
The study, Gestational Diabetes – Risk Factors and Outcomes among American Samoan Women (GROW), is the first long-term, population-specific investigation into why so many Pacific Islander women develop gestational diabetes, and why some progress rapidly to type 2 diabetes after giving birth.
“We are anticipating that the results of this study will be useful in a number of ways. We are expecting to find early biological and behavioral indicators of risk in this understudied population,” said Dr. Nicola Hawley, PhD, associate professor of epidemiology (chronic diseases), who is leading GROW. “A better understanding of who is at risk based on very early pregnancy data will help us direct preventative resources to those who need them most.”
Gestational diabetes mellitus (GDM) is a type of diabetes that has its onset in pregnancy. The condition increases the risk of complications during pregnancy, birth, and long term, with women with GDM having significantly heightened risk of developing type 2 diabetes later in life. During a normal pregnancy, women can expect an increase in blood sugar to support the growth of the baby. Usually, the body will compensate by producing more insulin, the hormone that controls blood sugar.
For some women, particularly those who already have some risk for type 2 diabetes, GDM happens when their bodies can’t keep up with that growing demand for insulin and their blood sugar increases. General risk factors include age, family history, obesity, and high blood pressure. But some populations, including Pacific Islanders, have much higher risk. According to Hawley, evidence from some of her earlier work showed that the prevalence of GDM may be as high as 40% among women in American Samoa versus only around 9% among women in the U.S. in general.
With investigators at the University of Pittsburgh, Emory University, and the Obesity, Lifestyle and Genetic Adaptations (OLaGA) Research Center in American Samoa, Hawley and her team are enrolling 350 Samoan women early in pregnancy and following them for 18 months postpartum.
Photo: Dr. Nicola Hawley
