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Thread: Medicating fetuses proposed, tests underway page

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    IvyBlue's Avatar
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    Medicating fetuses proposed, tests underway

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    Programming a Fetus for a Healthier Life - WSJ.com

    Excerpt: "In the study, which is taking place at five sites across the U.K., pregnant women who are obese but nondiabetic will be given a drug used to treat type-2 diabetes called Metformin over the course of their pregnancy. Obese women, even those who don't have diabetes, tend to have higher blood sugar during pregnancy, the researchers say. The glucose passes through the placenta to the fetus, causing the fetus to work harder to produce more insulin to deal with the higher levels of sugar. The babies tend to be born larger and to produce more insulin because their bodies expect to take in higher levels of glucose, Dr. Norman says.

    The researchers expect that the diabetes drug will lower the mothers' blood sugar, which in turn should reduce the amount of glucose passed to the fetus. The hoped-for outcome is that the babies are smaller at birth and have metabolisms that don't come out churning insulin and aren't predisposed towards obesity.

    "What we're trying to do is change the thermostat for the baby," says Andrew Weeks, an investigator for the study from the University of Liverpool. 'Once it's set, it can't be altered for life.'"

    I am beyond anger at the medication of symptoms rather than attacking root causes in adults but at least adults have some semblance of choice. But fetuses? I'm speechless.
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    I am pissed at the thought that ALL obese pregnant women have high blood sugars.
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    For me, that goes beyond scary to unethical and horrifying.
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    Why aren't they looking at the cause?
    /facepalm
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    Okay, the pot is cooked. You have an obese pregnant woman. There is an indication that the genetic programming that happens during the pregnancy caries through not just to the fetus, but to the generation after that. And you think there's something wrong with using a very safe drug that is already used in many pregnancies to try to change that? Now that I do not get.
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    Well that sounds like smart medicine to me. I cannot understand what someone would have against it. I'm serious. The mom screws up the fetus' metabolism by being obese, but a doctor trying to minimize that damage is evil? Don't get your logic.
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    Quote Originally Posted by Nion View Post
    ...
    Why aren't they looking at the cause?
    /facepalm
    They do typically advise women to get to a healthy weight before getting pregnant. Of course, their advice on how to do so is quite bad. However, regardless of how good the advice is, you cannot force people to delay pregnancy. Some obese women will get pregnant even if you gave them perfect tools for losing weight. I don't personally know enough about the drug protocol to know if its good or not, but if there is compelling evidence that it is better for the fetus for the woman to take the drug, then I don't see the problem with it being offered if she has high blood glucose. It's obviously not as good as if she got in better health prior to conception but that doesn't mean we should throw our hands up into the air rather than look for ways to intervene for the health of the child.

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    Not all obese women have high blood sugar. Not all women with high blood sugar are obese. I can sort of see this if we were talking about medicating women with high blood sugar, but instead, it's only targeted at obese women.

    Additionally, we don't know what effects Metformin might have on a fetus. Many drugs that are safe for adult human bodies are very dangerous to a developing fetus (Thalidomide anyone?), and I'm not convinced that the possible reduction in lifetime obesity risk is worth the possible harm the drug might do.

    Why not simply put women with blood sugar issues on dietary regimes that help control elevated blood sugar, at least for the duration of their pregnancies? That route seems to pose the least risk of harm to a developing fetus, offers the best potential health benefits to the mother, and might even see better long term health outcomes for both mother and child if some of that dietary change sticks after the woman gives birth. I'm not anti-drug (some of them have saved my life and/or allow me to live a more normal daily life), but it seems to me that a dietary intervention is far more favorable and simple in cases where it could be applied.
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    The way to address this problem ethically would be to treat the women's obesity. But we all know that they are lazy, slothful, non-compliant patients that simply refuse to follow doctors' advice. And the trials are merely pro-forma, we already know that the fetuses won't be harmed (after all, the Dr's took an oath) and so what if the women don't actually have the condition the medicine was designed to treat?
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    Metformin is often used to help the effectiveness of stims during IVF and also reduces the risk of first trimester miscarriages in non insulin resistant people as well as those with IR. It has been used by women with pcos and GD during pregnancy for many, many years.
    The only side effect so far when used properly is that it occasionally causes fetuses to be born with lowish blood sugar. But so are plenty of fetuses born without metformin.
    Obese women have been prescribed metformin to get and stay pregnant for decades.
    Yes, in a perfect world we would be able to address these issues with diet, but it isn't easy when you're told to eat the wrong way all the time.
    This study isn't a new thing. I don't see it as a big deal.

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