Intended for healthcare professionals

Rapid response to:


Birth characteristics of women who develop gestational diabetes: population based study

BMJ 2000; 321 doi: (Published 02 September 2000) Cite this as: BMJ 2000;321:546

Rapid Response:

Re: Response to letters on nutrition and smoking

I thank Dr. Egeland and other respondents to her article for
considering possible acute and nutritional roles of smoking in gestational
diabetes and low birth weight in mother-daughter pairs. I agree with
suggestions in other eBMJ responses to the Egeland et al article, that
both communication of smoking from mothers to daughters and other factors
may contribute to gestational diabetes and low birth weight. In
particular, maternal smoking can cause chronic effects by exposing fetuses
to gestational hyperglycemia and low birth weight from smoking.

I disagree with Dr. Egeland's response implying that smoking does not
contribute acutely or chronically to impaired glucose tolerance in
childhood. Large fractions of adolescents and pregnant women in Europe and
America smoke.1 Consequently, both acute and fetal diabetogenic effects of
tobacco could contribute to impaired glucose tolerance in childhood.

I have no funding or conflicts of interest in relation to this study
or this letter.

1. World health report 1999: making a difference. Geneva: World
Health Organization, 1999.

Competing interests: No competing interests

15 September 2000
Bruce N Leistikow
Adjunct Associate
University of California, Davis