Cord blood test could predict a baby's risk of type 2 diabetes

A genetic test of cord blood at birth may hold the key to predicting a child’s future risk of developing type 2 diabetes. By analysing the DNA in cord blood from babies born to mothers with gestational diabetes or high blood sugar during pregnancy, researchers have identified early epigenetic markers that forecast insulin resistance and beta-cell dysfunction up to 18 years before diabetes develops.

Published in the journal Diabetes, these findings from Melbourne’s Baker Heart and Diabetes Institute and The Chinese University of Hong Kong (CUHK) offer a major step forward in personalised medicine. The study was co-led by Professor Sam El-Osta, Head of the Baker Institute’s Epigenetics team, and Professor Ronald Ma from CUHK.

“We know children born to mothers with gestational diabetes during pregnancy face a greater risk of developing metabolic disorders like type 2 diabetes later in life,” El-Osta said. “Until now, identifying which children are most at risk has been difficult, and existing tools — such as birth weight, fat mass or cord blood insulin — have been limited in their ability to predict the development of the disease.

“This research points to a future where we can identify a newborn’s risk of type 2 diabetes at birth and take steps immediately to reduce that risk.”

The new study is said to offer the first longitudinal demonstration that epigenetic markers found in cord blood can be used to assess lifelong diabetes risk, with epigenetic signatures in cord blood found to improve the prediction of beta cell dysfunction by 79% compared to traditional clinical markers used in adult testing like fat mass or C-peptide. After assessing children and young people aged seven, 11 and 18 years, the team have found that as well as predicting risk of type 2 diabetes as early as birth, the technique can be relied upon as a strong predictor through childhood to adolescence.

These findings thus pave the way for personalised prevention programs, such as lifestyle or dietary adjustments from early childhood, allowing action decades before disease onset. The researchers believe the cord blood test could become part of neonatal screening panels and inform protective strategies from early childhood to reduce metabolic dysfunction and diabetes risk long before the disease develops.

“The study shows mothers who have glucose levels below what is currently diagnosed as gestational diabetes can pass on this metabolic risk to their babies,” El-Osta said. “This suggests implications for much earlier screening and intervention.”

Indeed, if mothers are found to have high blood sugar during their pregnancy, doctors could better support them to lower their glucose and help reduce the risk for the next generation. The study also highlights the need for stronger education programs emphasising a healthy diet and lifestyle throughout pregnancy to reduce the risk of developing high blood sugar.

The researchers are hoping to conduct further clinical trials before looking to commercialise and translate the test into clinical practice.

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