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Anthropometry, Glucose Tolerance, and Insulin Concentrations in Indian Children

Relationships to maternal glucose and insulin concentrations during pregnancy

¹ CSI Holdsworth Memorial Hospital, Mysore, South India
² MRC Epidemiology Resource Centre, Southampton General Hospital, Southampton, U.K

Address correspondence and reprint requests to Dr. G.V. Krishnaveni, Post Box 38, Holdsworth Memorial Hospital, Mandi Mohalla, Mysore 570021, Karnataka, India. E-mail: kittyveni{at}hotmail.com

OBJECTIVE—The purpose of this study was to test the hypothesis that the environment experienced by fetuses of mothers with gestational diabetes mellitus (GDM) and mothers with higher glucose concentrations that are in the normal range causes increased adiposity and altered glucose/insulin metabolism in childhood.

RESEARCH DESIGN AND METHODS—Children (n = 630) whose mothers were tested for glucose tolerance during pregnancy had detailed anthropometry performed at birth and annually thereafter. At 5 years, plasma glucose and insulin concentrations were measured in the children (2-h oral glucose tolerance test) and their fathers (fasting samples only).

RESULTS—Newborns of diabetic mothers (n = 41) were larger in all body measurements than control newborns (babies with nondiabetic parents). At 1 year, these differences had diminished and were not statistically significant. At 5 years, female offspring of diabetic mothers had larger subscapular and triceps skinfold thicknesses (P = 0.01) and higher 30- and 120-min insulin concentrations (P < 0.05) than control children. Offspring of diabetic fathers (n = 41) were lighter at birth than control children (P < 0.001); they showed no differences in anthropometry at 5 years. In control children, skinfold thickness and 30-min insulin concentrations were positively related to maternal insulin area under the curve, and skinfold thicknesses were related to paternal fasting insulin concentrations independently of the parents’ skinfold thickness and socioeconomic status.

CONCLUSIONS—Maternal GDM is associated with adiposity and higher glucose and insulin concentrations in female offspring at 5 years. The absence of similar associations in offspring of diabetic fathers suggests a programming effect in the diabetic intrauterine environment. More research is needed to determine whether higher maternal glucose concentrations in the nondiabetic range have similar effects.

Abbreviations: GAUC, glucose area under the curve • GDM, gestational diabetes mellitus • HMH, Holdsworth Memorial Hospital • HOMA, homeostasis model assessment equation • IAUC, insulin area under the curve • IGT, impaired glucose tolerance • ODM, offspring of diabetic mothers • OGTT, oral glucose tolerance test • ONDM, offspring of nondiabetic mothers

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