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Insulin Sensitivity in the Offspring of Women With Type 1 and Type 2 Diabetes

¹ Liggins Institute, Faculty of Medicine and Health Sciences, The University of Auckland, Auckland, New Zealand
² Department of Medicine, Faculty of Medicine and Health Sciences, The University of Auckland, Auckland, New Zealand
³ Department of Pediatrics, Faculty of Medicine and Health Sciences, The University of Auckland, Auckland, New Zealand
⁴ Department of Community Health, Faculty of Medicine and Health Sciences, The University of Auckland, Auckland, New Zealand

Address correspondence and reprint requests to Dr. Wendy Hunter, Liggins Institute, Faculty of Medicine and Health Sciences, The University of Auckland, Private Bag 92019, Auckland, New Zealand. E-mail: w.hunter{at}auckland.ac.nz

OBJECTIVE—To determine if insulin sensitivity is altered in prepubertal offspring exposed to a diabetic intrauterine environment.

RESEARCH DESIGN AND METHODS—Fifteen control children, 17 offspring of type 1 diabetic women, and 10 offspring of type 2 diabetic women, aged between 5 and 10 years, underwent a frequently sampled intravenous glucose tolerance test (FSIGTT). Weight and height were measured, and body composition was calculated using bioelectrical impedance. Bergman’s minimal model was applied to the glucose and insulin measurements to obtain values for insulin sensitivity (S_i), acute insulin response (AIR), and glucose effectiveness (S_g).

RESULTS—S_i was lowest in the offspring of type 2 diabetic mothers, and AIR was highest in this group, although neither of these changes reached significance (S_i, P = 0.2, and AIR, P = 0.3). Offspring of type 2 diabetic mothers had higher BMI SD scores (P = 0.004) and percentage fat mass (P = 0.002) than the children in the other two groups. The BMI SD score and percentage fat mass in the subjects, as well as maternal insulin dose, were negatively correlated with offspring insulin sensitivity.

CONCLUSIONS—Intrauterine exposure to hyperglycemia by itself was not associated with alterations in glucose regulation in prepubertal offspring. Children of mothers with type 2 diabetes, however, were overweight, and they had a tendency for a reduced S_i. The combined effect of genetic and postnatal environmental factors, rather than prenatal exposure to hyperglycemia, may place this group at risk for developing impaired glucose tolerance in later life.

Abbreviations: AIR, acute insulin response • FSIGTT, frequently sampled intravenous glucose tolerance test

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