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The link between miscarriage and insulin resistance

(WNDU)
Published: Jan. 17, 2020 at 3:54 PM EST
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The joy of pregnancy can quickly turn to fear when multiple miscarriages occur, especially when those miscarriages have no explanation.

But researchers discovered why a woman's blood sugar levels may be a factor.

As many as one in four pregnancies end in miscarriage each year, and it can be a heartbreaking experience for women.

"I felt kind of alone, even though I know my husband was there with me and my family knew about it, but I felt alone because they weren't experiencing what I was experiencing," Devani Conner said.

After three miscarriages, Conner sought help from Dr. Mark Trolice at the IVF Center. He understands what it's like to be in her shoes.

"My wife and I went through ten years of infertility," he said. "Ten years of struggle, of watching my patients cry during the day and my wife cry at night. And finally, we resolved by adopting our five children."

Some miscarriages can be caused, in part, by hormonal problems, older age and poor lifestyle like obesity and smoking. But 50% are unexplained.

Now, a study published in the journal Fertility and Sterility says that insulin resistance might be a culprit.

"What we're seeing is that in patients who have abnormal blood sugar control as well as prediabetes, and another word for that is insulin resistance, that may be associated with miscarriage," Trolice said.

High insulin levels are toxic to the placenta. Trolice says women who have had a miscarriage should be screened for blood sugar control.

"And if that's abnormal, we get that more normalized with medication," Trolice said.

Along with medication, women can adjust their diet to increase their chance of having a healthy baby

Although it's been known that insulin resistance is linked to miscarriage, this study was the first to understand that the insulin severely damaged placenta cells.

The common diabetes drug metformin can now be prescribed to help women at risk.

RESEARCH SUMMARY

THE LINK BETWEEN MISCARRIAGE AND INSULIN RESISTANCE

REPORT #2711

BACKGROUND: Miscarriage is the most common type of pregnancy loss, according to the American College of Obstetricians and Gynecologists (ACOG). Studies reveal that anywhere from 10 to 25 percent of all clinically recognized pregnancies will end in miscarriage. Most miscarriages occur during the first 13 weeks of pregnancy. During the first trimester, the most common cause of miscarriage is chromosomal abnormality, meaning that something is not correct with the baby's chromosomes. Most chromosomal abnormalities are the cause of a damaged egg or sperm cell or are due to a problem at the time that the zygote went through the division process. Women are often left with unanswered questions regarding their physical recovery, their emotional recovery and trying to conceive again. It is very important that women try to keep the lines of communication open with family, friends and health care providers during this time. (Source: https://americanpregnancy.org/pregnancy-complications/miscarriage/)

LINK BETWEEN MISCARRIAGE AND INSULIN RESISTANCE: Chief of the Division of Reproductive Endocrinology and Infertility at Columbia University Irving Medical Center, Zev Williams, MD, PhD, recently co-authored a study published in the journal Fertility and Sterility examining the effects of insulin and metformin on placenta cells from first-trimester pregnancies. Insulin resistance, defined as impaired metabolic response to insulin, affects 34 percent of the U.S. population (84 million people). Insulin, even at levels found in patients with insulin resistance, is toxic to the early placenta cells. The risks in pregnancy from diabetes, especially uncontrolled, includes birth defects, miscarriage, stillbirth, high blood pressure, large birth weight, and early birth. When placenta cells were cultured in the presence of metformin, a commonly used medication for the treatment of insulin resistance, the placenta cells were protected from damage. Clinical trials are needed to validate these results in patients, however this study has changed how screening for insulin resistance is done. Dr. Mark Trolice adds proper diet, like the Mediterranean diet, along with daily exercise as recommended by the American Heart Association, is valuable to improving health, fertility, pregnancy, and baby! (Source: https://www.columbiaobgyn.org/news/study-reports-high-insulin-levels-are-toxic-placenta-cells-potentially-causing-miscarriages)

BREAKTHROUGH DISCOVERY: Having low levels of a molecule called nicotinamide adenine dinucleotide (NAD) damages embryos in the crucial first weeks of pregnancy when organs start forming. A groundbreaking study uncovered a potential preventative: vitaminB3 (or niacin) supplements before and during pregnancy could prevent miscarriages and birth defects caused by NAD deficiency. "This has the potential to significantly reduce the number of miscarriage and birth defects around the world, and I do not use those words lightly," said the study's senior researcher Professor Sally Dunwoodie at the Victor Chang Institute. The researchers sequenced the genes of four families who had a history of miscarriages and babies with multiple birth defects, including congenital heart, vertebral, and kidney malformations. They identified two gene mutations that affected the metabolic pathway that produced NAD – crucial for gene development and repair. Some 80 percent of birth defects had no known cause, and NAD levels could explain a significant proportion of these malformations. (Source: https://www.smh.com.au/healthcare/breakthrough-discovery-finds-cause-and-affordable-cure-for-miscarriage-multiple-births-defects-victor-chang-institute-scientists-announce-20170809-gxsq6k.html)

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