Diabetes in Pregnancy for Mothers and Offspring: Reflection on 30 Years of Clinical and Translational Research: The 2022 Norbert Freinkel Award Lecture.
Diabetes in Pregnancy for Mothers and Offspring: Reflection on 30 Years of Clinical and Translational Research: The 2022 Norbert Freinkel Award Lecture.
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怀孕期间的高血压是一把双刃剑，影响母亲及其后代，并形成一个可能影响多代人的恶性循环。过去30年来，这一领域的研究大大提高了我们对这一疾病的认识，并为改善母婴健康的战略奠定了基础。尽管取得了这一进展，妊娠期糖尿病和先前存在的糖尿病继续对母亲及其后代的短期和长期健康产生重大影响。在这篇文章中，我概述了我和我的同事在以下四个方面为推进糖尿病和妊娠知识基础所做的工作：1）妊娠期糖尿病（GDM）后的糖尿病风险，包括种族和民族差异; 2）西班牙裔女性GDM和随后的糖尿病的病理生理学; 3）GDM后的糖尿病预防和β细胞保护;和4）根据妊娠期间母体糖尿病暴露的时间和严重程度，后代中多种潜在发育影响的证据。这项研究延续了Norbert Freinkel的遗产，以及他对糖尿病和妊娠领域的贡献。随着肥胖症的流行，年轻人1型和2型糖尿病的发病率增加，以及所有种族和民族GDM患病率的上升，我们还有很多工作要做，以对抗这种疾病，打破恶性循环。
Hyperglycemia during pregnancy is a double-edged sword, affecting both mothers and their offspring and creating a vicious cycle that can affect multiple generations. Research in this field over the past 30 years has greatly improved our understanding of this disease and formed the basis of improved strategies to improve the health of mothers and their babies. Despite this progress, gestational and preexisting diabetes continue to have significant effects on both short- and long-term health of mothers and their offspring. In this article, I provide an overview of the work that my colleagues and I have done to advance the knowledge base around diabetes and pregnancy in four areas: 1) diabetes risk after gestational diabetes mellitus (GDM), including racial and ethnic disparities; 2) the pathophysiology of GDM and subsequent diabetes in Hispanic women; 3) diabetes prevention and β-cell preservation following GDM; and 4) evidence for multiple potential developmental effects in offspring that vary according to the timing of exposure and severity of maternal diabetes during pregnancy. This research continues the legacy of Norbert Freinkel and the concepts that he contributed to the field of diabetes and pregnancy. With the epidemic of obesity, increasing rates of type 1 and type 2 diabetes in youth, and rising prevalence of GDM across all racial and ethnic groups, we have a lot more work to do to combat this disease to break the vicious cycle.