High prevalence of type 2 diabetes and pre-diabetes in adult offspring of women with gestational diabetes mellitus or type 1 diabetes: the role of intrauterine hyperglycemia

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Tine D Clausen, Elisabeth R Mathiesen, Torben Hansen, Oluf Pedersen, Dorte M Jensen, Jeannet Lauenborg, Peter Damm, Tine Dalsgaard Clausen, Elisabeth R Mathiesen, Torben Hansen, Oluf Pedersen, Dorte Jensen, Jeannet Lauenborg, Peter Damm

OBJECTIVE: The role of intrauterine hyperglycemia and future risk of type 2 diabetes in human offspring is debated. We studied glucose tolerance in adult offspring of women with either gestational diabetes mellitus (GDM) or type 1 diabetes, taking the impact of both intrauterine hyperglycemia and genetic predisposition to type 2 diabetes into account. RESEARCH DESIGN AND METHODS: The glucose tolerance status following a 2-h 75-g oral glucose tolerance test (OGTT) was evaluated in 597 subjects, primarily Caucasians, aged 18-27 years. They were subdivided into four groups according to maternal glucose metabolism during pregnancy and genetic predisposition to type 2 diabetes: 1) offspring of women with diet-treated GDM (O-GDM), 2) offspring of genetically predisposed women with a normal OGTT (O-NoGDM), 3) offspring of women with type 1 diabetes (O-type 1), and 4) offspring of women from the background population (O-BP). RESULTS: The prevalence of type 2 diabetes and pre-diabetes (impaired glucose tolerance or impaired fasting glucose) in the four groups was 21, 12, 11, and 4%, respectively. In multiple logistic regression analysis, the adjusted odds ratios (ORs) for type 2 diabetes/pre-diabetes were 7.76 (95% CI 2.58-23.39) in O-GDM and 4.02 (1.31-12.33) in O-type 1 compared with O-BP. In O-type 1, the risk of type 2 diabetes/pre-diabetes was significantly associated with elevated maternal blood glucose in late pregnancy: OR 1.41 (1.04-1.91) per mmol/l. CONCLUSIONS: A hyperglycemic intrauterine environment appears to be involved in the pathogenesis of type 2 diabetes/pre-diabetes in adult offspring of primarily Caucasian women with either diet-treated GDM or type 1 diabetes during pregnancy.
Original languageEnglish
JournalDiabetes Care
Volume31
Issue number2
Pages (from-to)340-6
Number of pages7
ISSN0149-5992
DOIs
Publication statusPublished - 1 Feb 2008

Bibliographical note

Keywords: Adult; Denmark; Diabetes Mellitus, Type 1; Diabetes Mellitus, Type 2; Diabetes, Gestational; Female; Genetic Predisposition to Disease; Glucose Tolerance Test; Humans; Hyperglycemia; Overweight; Prediabetic State; Pregnancy; Pregnancy Complications; Regression Analysis; Smoking

ID: 10001365