NIH launches study of long-term effects of blood glucose during pregnancy

Researchers to explore effects on body fat in children and development of diabetes in moms after giving birth

Researchers funded by the National Institutes of Health plan to determine whether elevated blood sugar during pregnancy, a less–severe condition than gestational diabetes, influences later levels of body fat in children and development of diabetes in mothers after giving birth.

The original study, the Hyperglycemia and Adverse Pregnancy Outcomes (HAPO), looked at 23,316 mother-child pairs and found that a mother’s blood sugar levels, even short of diabetes, were associated with her newborn’s birth weight and body fat.

The HAPO-Follow-up Study (HAPO-FUS) seeks to recruit 7,000 of the original HAPO mother-child pairs for a single visit to one of 10 of the original HAPO clinical centers. Mothers and children (now ages 8 to 12 years), will have their height, weight, blood pressure, body fat, blood sugar, insulin, and blood fats measured.

“The goal of this study is to determine the levels of blood sugar during pregnancy that are linked to increased body fat in the child, and to a mother’s chances of developing diabetes 8 to12 years after her pregnancy,” said Mary Horlick, M.D., project scientist and director of the Pediatric Clinical Obesity Program at the NIH’s National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). NIDDK and NIH’s Eunice Kennedy Shriver National Institute of Child Health and Human Development are jointly sponsoring HAPO-FUS.

Launched in 2000, the original HAPO study was funded by NIH and conducted at 15 clinical centers in nine countries. HAPO sought to determine whether high sugar levels, less severe than diabetes, were associated with adverse pregnancy and birth outcomes. The women underwent a 75-gram, 2-hour oral glucose tolerance test between the 24th and 32nd week of pregnancy.

In the first HAPO study, researchers also found that women with higher glucose levels also had an increased risk of needing a cesarean section. These results were found across the clinical centers and led an international panel of experts to recommend new diagnostic criteria for gestational diabetes, a form of diabetes that develops during pregnancy, in 2010. However, not all professional groups have adopted these proposed criteria.

“This research will help determine if these new lower blood sugar cutpoints effectively predict later type 2 diabetes in the mothers and overweight, obesity, and disorders of glucose metabolism in their offspring,” said principal investigator, Boyd Metzger, M.D., Tom D. Spies Professor of Metabolism and Nutrition at the Northwestern University Feinberg School of Medicine, Chicago.

The HAPO-FUS clinical centers are:

  • Northwestern University and Lurie Children’s Hospital, Chicago
  • Kaiser-Permanente Southern California Department of Research and Evaluation, Downey, Calif.
  • Case Western Reserve University at Metro Health Medical Center, Cleveland
  • The Hospital for Sick Children, Toronto
  • Rajavithi Hospital, Bangkok
  • The University of the West Indies, Bridgetown, Barbados
  • Royal Victoria Hospital, Belfast, Northern Ireland
  • The Chinese University of Hong Kong
  • Royal Manchester Children’s Hospital, Manchester, England
  • Helen Schneider Hospital for Women, Petah Tikva, Israel

While research continues, the NIH’s National Diabetes Education Program’s (NDEP) campaign, It’s Never Too Early…To Prevent Diabetes, encourages women who have had gestational diabetes to be tested for diabetes six to 12 weeks after their baby is born, eat smaller amounts of food to reach and stay at a healthy weight, and be active each day. Women with the following risk factors are more likely to develop gestational diabetes:

  • Overweight or obese
  • A strong family history of diabetes
  • A previous diagnosis of gestational diabetes
  • Being African-American, American Indian, Asian-American, Hispanic/Latino, or Pacific Islander


The NIDDK, a component of the National Institutes of Health (NIH), conducts and supports research on diabetes and other endocrine and metabolic diseases; digestive diseases, nutrition and obesity; and kidney, urologic and hematologic diseases. Spanning the full spectrum of medicine and afflicting people of all ages and ethnic groups, these diseases encompass some of the most common, severe, and disabling conditions affecting Americans. For more information about the NIDDK and its programs, see

The NICHD sponsors research on development, before and after birth; maternal, child, and family health; reproductive biology and population issues; and medical rehabilitation. For more information, visit the Institute’s website at

About the National Institutes of Health (NIH): NIH, the nation's medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit

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