Diabetes Medication During Pregnancy May Be Linked to ADHD
Anti-diabetic medications like insulin are often used to treat type II or gestational diabetes in people who are pregnant — but new research indicates that this might be linked to an increased risk of attention deficit disorder in the child.
Reviewed on April 5, 2017
September 26, 2016
Taking diabetes medication during pregnancy may increase the risk of a child later developing ADHD, according to a new study — though some experts in the field of diabetes aren’t yet convinced that there is cause for concern.
The study, conducted by a team from Kaiser Permanente and the University of Southern California, was presented September 16 at the annual meeting of the European Association for the Study of Diabetes. Information from Kaiser’s electronic medical record database was used to track pregnancies that came to term between 1995 and 2009. Nearly 135,000 children from the Southern California area whose families were members of Kaiser or who went to Kaiser hospitals were included in the study. Of those, approximately 25,000 had mothers who were dealing with diabetes — either type II or gestational — during their pregnancy. Approximately 7,500 children had mothers who took medication to treat their diabetes — primarily insulin.
The rates of ADHD were similar across the board — around 4 percent overall. But, the researchers said, children whose mothers had diabetes and took medicine for it had a statistically significant risk increase — about 23 percent — of having ADHD than children whose mothers had diabetes but did not take medication for it. Of the women with type II diabetes, 47 percent took medicine during pregnancy. For women with gestational diabetes, the rate was 29 percent. The results only appeared if the mother took medication for more than 60 days, the researchers said.
After being presented with the data, panel moderator Alexandra Kautzky-Willer, M.D., was skeptical of the conclusions drawn by the researchers. “These results are interesting, but we cannot say that insulin has a negative effect on offspring,” she said. “It would be good to know about the hyperglycemic states of patients, which were not actually discussed but might be related to the outcomes.”
In addition to her concerns, Kaiser’s role as a Southern California hospital network and insurance provider may have imposed further limitations on the research. For one, data was tracked until the subjects either died or left the Kaiser umbrella — meaning that additional diagnoses or mitigating factors could’ve been missed if a patient changed insurance companies. On top of that, it’s unclear if factors related to the location — Southern California — came into play in the results.
Panel moderator Adam Tabak, M.D., Ph.D., thinks these potential limitations should be taken seriously. “Some unmeasured confounders could be behind these findings,” he said. “These women could be socioeconomically very different.”
“I wouldn’t rush to any conclusions at this stage,” he added. “We need more phenotypically defined details of the population and to catch the unmeasured confounders.”
Anny Xiang, Ph.D., one of the lead authors of the study, acknowledged the limitations, but firmly believes the study’s results warrant further research — particularly when it comes to what appears to be a two-month grace period for taking diabetes medication without negative effects.
“We wonder if the increased duration [of use] might be a surrogate for the severity of diabetes during pregnancy and that this might be the surrogate for the increasing risk of ADHD,” she said.