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Mother Load: Arsenic May Contribute to Gestational Diabetes

Environmental Health Perspectives
Environmental Health Perspectives
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A 310 volume 117 | number 7 | July 2009 • Environmental Health Perspectives Mother Load Arsenic May Contribute to Gestational Diabetes Chronic exposure to arsenic—usually via drinking water contami- nated with inorganic arsenic—has been associated with an increased risk of type 2 diabetes mellitus in countries around the world. New research shows that arsenic exposure may be an environmental risk factor for gestational diabetes as well [EHP 117:1059–1064; Ettinger et al.]. Arsenic may promote type 2 dia- betes by increasing insulin resistance (inability to utilize insulin at the cellular level) and impairing insulin production. Insulin resistance is also a central fea- ture of gestational diabetes, a potential complication during pregnancy that can lead to a 30–60% increased risk for the mother of developing lifelong diabetes, as well as impaired glucose tolerance, adverse birth outcomes, and obesity in her child. The study was conducted near the Tar Creek Superfund site in Ottawa County, Oklahoma, whose residents include many Native Americans, a popu- lation already at elevated risk for type 2 diabetes. The area, once active in lead and zinc mining, has an above-average poverty rate compared with the rest of Oklahoma and the nation. Mine waste contaminated with assorted metals is still present and has been used to build roads, playgrounds, driveways, and house foundations. Moreover, 25% of drink- ing water samples tested in the area have naturally occuring arsenic levels exceeding the Environmental Protection Agency maximum contaminant level of 10 µg/L. Total arsenic concentrations were measured in blood and hair samples collected at delivery from 532 women; blood was available from all women and hair from a subset of 179. Routine prenatal glucose tolerance tests conducted between weeks 24 and 28 of preg- nancy yielded plasma glucose measurements, and questionnaires and medical record review provided data on sociodemographic character- istics, potential

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