Maternal diabetes, even when controlled with insulin and blood sugar levels are kept mostly in check, can cause permanent damage to the fetus and birth defects, according to a recent study.

The findings of the study were published in the journal Science Advances. More than 3 million women of birthing age in the US and 60 million in the world have diabetes -- a disease that occurs when blood sugar is too high. About 300,000 to 400,000 fetuses per year from mothers with diabetes develop neural tube defects -- when the tissue that eventually forms the brain and spinal cord fails to form properly -- which can lead to miscarriage or profound disability.

Using studies, University of Maryland School of Medicine (UMSOM) researchers have identified the mechanism behind these structural birth defects, which they say is due to the neural tissue ageing prematurely, halting its growth before it has made enough cells to finish forming the neural tube.

"Although diabetes is a disease generally associated with an older population, the modern diabetes epidemic in young people is largely fueled by obesity and inactivity. At the same time, many ageing-related diseases are impacted by diabetes, and we now know that high blood glucose seems to induce or enhance premature embryonic ageing," said Dr Yang.

"For many decades, our hypothesis was that premature ageing, known as senescence, was occurring in the fetuses of mothers with diabetes, and was, in part, inducing these birth defects. It was only recently that we have had the tools and technology to be able to test our hypothesis," added Dr Yang.

Finding the precise mechanism for how maternal diabetes leads to these and other kinds of birth defects in the fetus is the first step to identifying a way to prevent these abnormalities from occurring.  Their findings suggested that more specialised therapies could be developed to prevent miscarriages or birth defects in babies born from mothers with diabetes. 

"Our next step is to see if birth defects of the heart and kidney found in fetuses born from mothers with diabetes are caused by the same senescence mechanism. If so, it would suggest that we can develop a single treatment more specialised to these developmental processes to prevent this spectrum of birth defects," said Dean Reece.

"As mothers with diabetes have children with five times the birth defect rate compared to the general population and incidence of diabetes is ever-increasing, it is imperative that we develop ways to prevent disability and promote healthy births," added Dean Reece.