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Omega 3 fatty acid supplementation in diabetic pregnancy

Implications for the Genesis of Diabetogenic Factors in the Offspring

In diabetic pregnancies there is an increased risk of birth defects and we have discovered a membrane defect in diabetic pregnant women, the consequences of which are passed on to the fetus.

Our previous work on diabetes in pregnancy at St Thomas' Hospital funded by The Mother and Child Foundation and Diabetes UK has uncovered a disturbing metabolic deficiency of omega-3 fatty acids in blood cell membranes in the mother that also appears in the blood of the new born child. We have evidence that this deficiency during fetal life retards brain development and harms the development of the arteries. Moreover we have evidence which gives reason to believe this deficit is causative of prenatal programming of vascular disorder and neurological deficits in the fetus that will affect health in adult life. Therefore we consider it of vital importance to establish if supplementation can correct the deficits in the mother and so help protect both her and the fetus.

Currently, fish oil supplement trial in diabetic pregnancy is in progress at the Newham University Hospital, London in collaboration with Professor Ovrang Djahanbakhch and a team of research midwives, Joanne Hutchinson and Irene Namuquer.

This work is funded by The Mother and Child Foundation, The Foyle Foundation, The Letten Foundation, Vifor Pharma, FP6 Maarie Curie Actions-Transfer of Knowledge (MTKD-CT-2005-029914), Sir Halley Stewart Trust, Newham University Hospital NHS Trust, and Diabetes Research Network (North East London Diabetes Local Research Network).

This trial is registered with Current Controlled Trials (registration number ISRCTN68997518) and the study protocol can be downloaded DM & Omega 3-Study Protocol.pdf .

Published Papers

Cabello-Moruno R, Min Y, Hallot A, Hutchinson J, Mariniello K, Djahanbakhch O, Ghebremeskel K, Crawford M. Erythrocyte membrane phospholipid molecular species in pregnant women with gestational and type 2 diabetes. International Society for the Study of Fatty Acids and Lipids (ISSFAL), May 29 – June 2 2010, Maastricht, The Netherlands

Thomas B, Ghebremeskel K, Lowy C, Offley-Shore B, Crawford MA. Nutrient intake of women with and without gestational diabetes with a specific focus on fatty acids. Nutrition 2006; 22:230-236

Min Y, Lowy C, Ghebremeskel K, Thomas B, Offley-Shore B, Crawford M. Unfavorable effect of type 1 and type 2 diabetes on maternal and fetal essential fatty acid status: a potential marker of fetal insulin resistance. Am J Clin Nutr 2005; 82: 1162-1168.

Thomas B, Ghebremeskel K, Lowy C, Min Y, Crawford MA. Plasma fatty acids of neonates born to mothers with and without gestational diabetes. Prostaglandins Leuko Essent Fatty Acids 2005; 72(5):335-341.

Min Y, Lowy C, Ghebremeskel K, Thomas B, Bitsanis D, Crawford MA. Fetal erythrocyte membrane lipids modification: Preliminary observation of en early sign of compromised insulin sensitivity in the offsprings of gestational diabetics. Diab Med 2005; 22:914-920.

Ghebremeskel K, Thomas B, Lowy C, Min Y, Crawford MA. Type 1 diabetes compromises plasma arachidonic and docosahexaenoic acids in newborn babies. Lipids 2004; 39(4):335-342.

Min Y, Ghebremeskel K, Lowy C, Thomas B, Crawford MA. Adverse effect of obesity on red cell membrane arachidonic and docosahexaenoic acids in gestational diabetes. Diabetologia 2004; 47(1): 75-81

Thomas B, Ghebremeskel K, Lowy C, Min Y, Crawford MA. Plasma AA and DHA levels are not compromised in newly diagnosed gestational diabetic women. Eur J Clin Nutr 2004; 58:1492-1497.

Ghebremeskel K, Bitsanis D, Koukkou E, Lowy C, Poston L and Crawford M. Liver triacylglycerols and free fatty acids in streptozotocin-induced diabetic rats have atypical n-6 and n-3 pattern. Comp Biochem Physiol C Toxicol Pharmacol 2002; 132(3):349 -354.

Ghosh P, Bitsanis D, Ghebremeskel K, Crawford MA and Poston L. Abnormal aortic fatty acid composition and small artery function in offspring of rats fed a high fat diet in pregnancy. J Physiol 2001; 533.3:815-822.

Ghebremeskel K, Bitsanis D, Koukkou E, Lowy C, Poston L and Crawford MA. Post natal modulation of heart and liver phosphoglyceride fatty acids in pups. Ann Nutr Metab 1999; 43: 365-373.

Ghebremeskel K, Bitsanis D, Koukkou E, Lowy C, Poston L and Crawford MA. Maternal diet high in fat reduces docosahexaenoic acid in liver lipids of newborn and sucking rat pups. Br J Nutr 1999; 81: 395-404.

Crawford MA, Lowy C, Koukkou E, Poston L, Ghebremeskel K. Sex ratio of offspring of diabetics. Lancet 1998; 351(9114):1515-1516.

Ghebremeskel K, Thomas B, Min Y, Stacey F, Koukkou E, Lowy C, Erskine K, Crawford M adn Offley-Shore B. Fatty acids in pregnant diabetic women and neonates: Implications for growth and development. In: Essential Fatty Acids and Eicosanoids, Invited Papers from the Fourth International Congress. Riemersma RA et al. (eds), Champaign, Illinois, 1998, p104-107.