It’s a health problem we are all aware of and it’s becoming more common. You are born with it or develop it in later life, Diabetes is on the increase with type two diabetes in correlation with the Nation’s increase in weight gain. Now, Liverpool has found the explanation behind poor birth contractions in diabetic women opening up the path for treatment during their labour.
Prof Susan Wray from the University has said “In the UK approximately 35,000 pregnant women per year have diabetes and some women develop the condition during pregnancy, a condition called gestational diabetes”. The researchers know that more than 60% of these women will require caesarean section to deliver their baby.
The University of Liverpool this month published findings from a study into uterus contractions in diabetic mums. Biopsies of the uterus from 100 diabetic and non diabetic women from Liverpool Women’s Hospital demonstrated that the contractions in diabetic women are far weaker than non diabetic women. Professor Susan Wray, from the University’s Institute of Translational Medicine, said: “We know that more than 60% of these women will need a caesarean section in order to deliver a baby successfully.” Of course as with any surgical procedures, caesarean section brings more possible medical problems, Prof Susan Wray says “These major operations increase the risk of complications and infection, as well as excessive bleeding and haemorrhage. Up until now we have not known why diabetic women suffer such complicated births, but it is important that more work is done in this field to prevent the further increase in emergency caesarean sections”.
Scientists at the University of Liverpool have worked with Liverpool Women’s Hospital for many years, the recent findings in diabetic pregnancy have been understood by comparing the changes in calcium activity within the muscle cells. Calcium is an essential component in all muscle cells including the uterus. During contraction calcium levels should increase to contract the uterus effectively, however researchers at Liverpool found the calcium levels to be significantly lower in diabetic contractions during birth. The research showed channels in the muscle cell membranes that allow entry of calcium into the cells were reduced, linking weaker contractions to lower calcium entry in diabetic mums.
This research has come at a peak time where the complications in diabetic births has increased in the region of 50% over the past 10 years. University of Liverpool is the first to achieve findings that understand why only a quarter of diabetic women will deliver their baby normally without caesarean.
At Liverpool the researchers found uterus tissue stimulated with the drug Oxytocin, also fails to reach the level of contraction in diabetic women, whereas it does in non-diabetic women. Oxytocin is commonly used as treatment in difficult births, it suggests why emergency caesarean is common in diabetes.
Professor Susan Wray who has led this research states: “Our work shows that calcium is inhibited from entering the muscle cells. This, together with evidence of reduced overall muscle mass, contributes to a poorly contracting uterus in women with diabetes. Future studies to help diabetic women should now focus on why the condition causes these changes in the first instance and if there is any way to stop it from happening.”
What is most important is that this new discovery is used in treatment of diabetic labours for the next generations, these findings are a target not just an explanation for the mystery that has been behind diabetes and difficult labours in women for many years.
