April 22, 2025, 11:46 am | Read time: 4 minutes
How does diabetes during pregnancy affect the development of a child’s brain? A large-scale meta-analysis now provides an alarming answer: Children of mothers with diabetes have a significantly higher risk of a variety of neurological developmental disorders, including autism. FITBOOK editor Sophie Brünke explains the study results in detail.
If a woman develops diabetes before or during pregnancy, the risk of neurological developmental disorders in the child increases, according to a new study published in the prestigious journal “The Lancet Diabetes & Endocrinology.” In Germany, the prevalence of diabetes among women was 9.2 percent in 2022.1 Some non-diabetic women develop diabetes during pregnancy: In 2020, 15 percent of pregnant women were diagnosed with gestational diabetes, and the trend is rising. Scientists suspect that the increase is due to more older and overweight pregnant women.2 Not only is the mother’s health affected, but gestational diabetes is also apparently linked to the development of autism and ADHD in children.
Overview
Objective of the Researchers
How does diabetes before or during pregnancy affect the development of the child’s brain? The study authors focused on numerous research works in their meta-analysis that already suggest links to disorders such as autism or ADHD. The aim of the analysis was to comprehensively consolidate the available evidence on neurological outcomes in children whose mothers had diabetes during pregnancy. Both gestational diabetes and pre-existing diabetes (Type 1 or Type 2 before pregnancy) were analyzed. The study examined intelligence, psychomotor development, and the risk of neurological disorders, focusing on children and adolescents up to 18 years old. The researchers aimed to provide a detailed picture of the risks associated with gestational diabetes and to highlight differences between the types of diabetes.3
Data from More Than 56 Million Mother-Child Pairs
The investigation is a systematic review with a meta-analysis. No new data were collected; instead, existing studies were systematically compiled and statistically evaluated. The data set included 202 studies from the literature databases PubMed, Web of Science, Embase, and EBSCO. Studies that analyzed the neurological development of children of diabetic mothers were included. In total, data from 56,082,462 mother-child pairs were evaluated. The evaluation was conducted using random-effects models, a statistical method that accounts for differences between studies.
Gestational Diabetes Increased Risk for Autism and Other Disorders
The meta-analysis found that children of mothers with diabetes have a 28 percent overall increased risk of neurological developmental disorders. Individual disorders also showed significant risk increases:
- Autism Spectrum Disorder: 25 percent increased risk
- ADHD (Attention Deficit/Hyperactivity Disorder): 30 percent
- Intellectual Disability: 32 percent
- Developmental Disorders (such as math, writing, language): 27 percent
- Communication Disorders: 20 percent
- Motor Disorders: 17 percent
- Learning Disorders: 16 percent
Pre-existing Diabetes Increased the Risk More Significantly
If the mother had diabetes before pregnancy, the risk increase was more pronounced than with gestational diabetes. The risk for neurological developmental disorders was 39 percent higher with pre-existing diabetes and 18 percent with gestational diabetes.
What Do the Results Mean About the Relationship Between Diabetes and Autism?
The results show that maternal diabetes during pregnancy is a significant risk factor for the child’s brain development. Affected children have a markedly increased risk of developing neurological disorders over their lifetime, especially if the diabetes existed before pregnancy. This suggests that not only blood sugar levels during pregnancy but also long-term metabolic changes may play a role. The findings are important not only for medical professionals and pregnant women but also for health policy and prevention programs. Better control of maternal diabetes, ideally before pregnancy, could reduce the risk of children developing neurological disorders.
Study Context and Possible Limitations
With over 56 million data sets, the study is one of the most comprehensive investigations into the impact of maternal diabetes on children’s neurological development. By considering numerous potential confounding factors (such as maternal age, education level, socioeconomic conditions), the study aimed to minimize biases. However, it remains a meta-analysis of observational studies, which cannot prove causality but only describe statistical associations. Additionally, the studies varied in diagnostic methods, age ranges covered, and data quality. The stronger association with pre-existing diabetes suggests that chronic metabolic stress in the mother plays a larger role than previously thought. The authors call for further prospective studies to clarify mechanisms and potential protective factors.
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Conclusion
Children of mothers with diabetes have a significantly increased risk of neurological developmental disorders such as ADHD, autism, or learning disabilities. This risk is particularly pronounced with pre-existing diabetes before pregnancy. The results underscore the importance of early blood sugar control, ideally even before conception.