Gayathri Wewala

Supervisor: Lisa K Hornberger

Project: Heart and blood vessel health of early teens of diabetic mothers

Degree program:

Medicine & Dentistry-Pediatrics

Lay abstract:

Children of diabetic mothers (CDMs) have been shown to have an increased risk of heart and blood vessel (cardiovascular disease, CVD) as adults. Maternal diabetes has been associated with the development of heart defects, heart muscle thickening, and reduced function in the fetus before birth. Very little is known about the factors that contribute to these abnormalities and how CVD progresses in CDMs. Hornberger's team has previously shown that the thickened heart muscle persists in late infancy. They also found that mothers with worse blood sugar levels during pregnancy had infants with a stiffer aorta, a major artery of the heart, and a potential risk factor for development of CVD. Recently, the team has shown in a smaller group of the same children that the thickened heart muscle and stiff aorta persist even in early childhood. The next step in establishing the evolution of CVD in children is to investigate whether these changes persist into adolescence and to better characterize the evolution of blood vessel dysfunction and other factors that potentially contribute to altered heart health long-term. In the present study, we will bring in new CDMs who are 10-14 years of age for assessments. This will include 30 CDMs and 30 children whose mothers were healthy. We will use non-invasive techniques such as blood pressure measurements and heart ultrasounds to assess heart function and structure, comparing findings between CDMs and control groups. We will use a questionnaire to assess diet, lifestyle, and physical activity. We also use activity monitors for 1-2 weeks to gage the average level of activity and will correlate activity with heart/blood vessel health parameters. We will correlate our findings with maternal pregnancy history, birth weight and body mass. Studies linking maternal health in pregnancy with long-term CVD of exposed infants enhance our understanding of the evolution of CVD and provide opportunities to prevent CVD development.

What motivated you to participate in this research?

Having participated in basic science research during my undergrad, I wanted the opportunity to expand my repertoire of research experiences and pursue a clinical project. Since I had already developed an interest in pediatrics from my previous experience working with children, this seemed like the perfect opportunity to pursue my interests and develop new skills. This project also provided the chance to work directly with children and their families to obtain consent and clinical measurements, to work alongside pediatric cardiologists and fellows to complete echocardiograms and functional testing and to develop skills in statistical analysis and academic writing. I was also eager to learn more about the fascinating fields of cardiology, endocrinology and obstetrics.

What are your career aspirations?

I'm very interested in becoming a pediatrician and integrating research into my future medical career. This summer has been a great introduction to clinical research and the various methodologies that can be utilized to answer scientific questions. As a member of the MD/STIR program, I'm excited to continue this project throughout the academic year and I can only hope that my experiences today will help me become a strong clinician-scientist in the future.

How has this studentship helped you toward those aspirations?

This has been an incredible summer. The WCHRI Summer Studentship has enabled me to conduct research that I find interesting and has allowed me to develop skills that I believe are invaluable to my future in medical research. I was also able to work with Lisa Hornberger, who has been an amazing mentor and a great example of the type of clinician-scientist I aspire to be.