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Mother’s diabetes may be tied to baby’s autism risk

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Pregnant women with any form of diabetes are at greater risk of having a child with an autism spectrum disorder, new research suggests.

Whether it’s type 1, type 2 or gestational diabetes, which specifically affects pregnant women, having the blood sugar disease might be linked to an increased autism risk, the researchers said.

“The risk appears to be highest in type 1, then type 2 and gestational diabetes,” said lead researcher Anny Xiang, director at the division of biostatistics research at Southern California Permanente Medical Group in Pasadena, California.

Autism’s causes remain somewhat mysterious, but in recent years research has pointed toward the the link between the condition, the immune system and the developing fetal brain.

Xiang cautioned that this study cannot prove that a mother’s diabetes causes autism, only that the two seem to be associated. A greater risk was seen when diabetes was diagnosed early in pregnancy, Xiang said.

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The findings — published online on June 23 in the Journal of the American Medical Association and presented at the American Diabetes Association annual meeting in Orlando, Fla — suggested that the risk varies by the type of diabetes and whether it was diagnosed early or late in pregnancy.

Thomas Frazier, chief science officer at Autism Speaks, an autism advocacy organization, pointed out that “the increases in risk aren’t huge.”

Frazier, who wasn’t involved in the new study, added, “I wouldn’t say that women should worry. It should motivate them to talk with their doctor and make sure their diabetes is controlled, because that’s the part they can control.”

For the study, Xiang’s team collected data on more than 419,000 children born from 1995 through 2012 in Kaiser Permanente Southern California hospitals.

More than 5,800 children developed autism during an average of seven years of follow-up from birth. Xiang’s team found that roughly 3 percent to 4 percent of those who developed autism had mothers with type 1 or type 2 diabetes that was diagnosed within 26 weeks of pregnancy.

For women with gestational diabetes, the risk was about 3 percent when the diabetes was diagnosed within 26 weeks of pregnancy.

Why diabetes might be tied to an increased risk for autism isn’t clear. It’s also not known if controlling diabetes would lower the risk, Xiang added.

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Autism, or autism spectrum disorder, is a range of conditions characterized by challenges with social skills, repetitive behaviors, speech and nonverbal communication.

According to the US Centers for Disease Control and Prevention, one in 59 children in the United States has some form of autism, including one in 37 boys and one in 151 girls.

The investigators found that infants of mothers with diabetes were at greater risk of developing autism than children whose mothers did not have diabetes.

Xiang said that “screening for autism risk for children born to mothers with type 1, type 2 and gestational diabetes diagnosed early during pregnancy may be warranted for early intervention.”

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Suicide can’t be predicted by asking about suicidal thoughts : Study

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Most people who died of suicide deny they experience suicidal thoughts when asked by doctors in the weeks and months leading up to their death, a major Australian study has found.

The findings, co-authored by clinical psychiatrist and Professor Matthew Large from UNSW’s School of Psychiatry, Sydney that published in the journal BJPsych Open The meta-analysis challenge the widely-held assumption that psychiatrists can predict who will suicide by asking if they are preoccupied with thoughts of killing themselves.

The study showed that 80% of patients who were not undergoing psychiatric treatment and who died of suicide reported not to have suicidal thoughts when asked by their psychiatrist or GP.

“If you meet someone who has suicidal ideation there is a 98 per cent chance that they are not going to suicide,” said Professor Large, an international expert on suicide risk assessment who also works in the emergency department of a major Sydney hospital.

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“But what we didn’t know was how frequently people who go on to suicide have denied having suicidal thoughts when asked directly,” he added.

“This study proves we can no longer ration psychiatric care based on the presence of suicidal thoughts alone. We need to provide high-quality, patient-centred care for everyone experiencing mental illness, whether or not they reveal they are experiencing suicidal thoughts,” Professor Large said.

About one in 10 people will have suicidal ideation in their lifetime. But the study showed suicidal ideation alone was not rational grounds for deciding who gets treatment and who does not, Professor Large said.

“We know that suicide feeling is pretty common and that suicide is actually a rare event, even among people with severe mental illness,” Professor Large added.

Suicidal ideation tells us an awful lot about how a person is feeling, their psychological distress, sometimes their diagnosis and their need for treatment but it’s not a meaningful test of future behaviour.

Suicidal feelings can fluctuate rapidly and people may suicide very impulsively after only a short period of suicidal thoughts.

But, people had good reasons not to disclose thoughts of suicide, fearing stigma, triggering over-reactions or upsetting family and friends, and being involuntarily admitted for psychiatric treatment, Professor Large said.

Professor Large emphasized that clinicians should not assume that patients experiencing mental distress without reporting suicidal ideas were not at elevated risk of suicide.

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