March 06, 2023 Improving diabetes outcomes after pregnancy

Who:

Dr. Jennifer Yamamoto, director of the Diabetes in Pregnancy Program and assistant professor, Department of Internal Medicine, University of Manitoba
 

Research highlights/discoveries:

• Using technology to improve the health of new mothers who have had gestational diabetes

Dr. Jennifer Yamamoto at a glance:

• Appointed assistant professor, Department of Internal Medicine, Division of Endocrinology and Metabolism, University of Manitoba (2020)

• Awarded the Associate Dean’s Letter of Excellence for Undergraduate Medical Education, University of Calgary (2020)

• Completed a fellowship in Internal Medicine, Royal College of Physicians and Surgeons, Ottawa (2015)

• Earned her Doctor of Medicine, University of Manitoba (2011)

How did you get interested in diabetes research?

During my medical training I loved being involved in the care of people with diabetes, which is a disease that can impact people throughout their lifetime. Then I specialized in diabetes in pregnancy (gestational diabetes) because woman’s health has always been a passion of mine. (Both my parents are obstetricians.) Research became a focus after I worked with some great mentors who showed me it could be fun and could be used to solve problems. Now I spend 75 percent of my time in research, five percent teaching, and 20 percent seeing patients with gestational diabetes at a Winnipeg clinic.

And gestational diabetes is your key research focus?

Yes. One in two people with gestational diabetes go on to develop type 2 diabetes later in life. In Manitoba, children of moms with gestational diabetes have a three times greater risk of developing type 2 diabetes in the first 30 years of their life.

What are you working on?

Technological advancements in diabetes are really exciting. For example, we see continuous glucose monitors (CGMs) changing people’s lives by making it so much easier for them to monitor their blood sugar throughout the day. But technology hasn’t been used as effectively in gestational diabetes. Few women who had gestational diabetes are screened for diabetes after pregnancy, even though their risk of subsequently developing type 2 diabetes is high—and the risk is higher for their babies, too. Our study will use CGMs postpartum to see if this can be a potential way to help diagnose type 2 diabetes sooner.

How will the study work?

We are recruiting 240 women in Winnipeg, Calgary, Toronto, and Quebec, all of whom have high-risk gestational diabetes (for example, who need medication or were significantly overweight during their pregnancy). By early 2023, we will start equipping these participants with a CGM sensor as soon as they deliver; they will wear it for two weeks while we monitor their blood sugar levels via an online platform. To gauge their experience using the CGMs, they’ll complete a questionnaire after using the sensor and then again six months after delivery when they do standard blood work, which doesn’t include the current test for diabetes after pregnancy (called the 75 g oral glucose tolerance test or OGTT). OGTT is challenging because new mothers need to come to a lab for several hours. For those who don’t go, that’s a lost opportunity to diagnose and manage diabetes in the early stages.

What do you hope to determine with the technology?

We hope the CGM will predict the risk of diabetes through the blood sugar data and help diagnose it with a follow-up OGTT. Because this study will allow us to access data on the participants’ blood sugar levels every five to 15 minutes, we will be able to see what their sugars look like throughout the day.

We want to determine if monitoring patients after they’ve given birth can provide insights into which women will develop diabetes complications or will develop more aggressive diabetes that will require insulin sooner. We also want to make postpartum screening for diabetes easier so that more people get tested.

The last word

“Dr. Yamamoto’s work is helping shine a light on women’s health issues, which have historically been underserved by research and clinical studies,” says Laura Syron, president and CEO of Diabetes Canada. “Her team’s innovative use of CGM technology to help improve outcomes for mothers and their children has the potential to prevent multiple generations of people from experiencing type 2 diabetes.”

Did you know?

One in two people with gestational diabetes will develop type 2 diabetes later in life, and their children are also at greater risk for type 2. Help us fund research like that of Dr. Yamamoto, which has the power to change lives. Donate now. #LetsEndDiabetes