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Published online March 28, 2008
Diabetes Care 31:1422-1426, 2008
DOI: 10.2337/dc07-2417
© 2008 by the American Diabetes Association
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Cardiovascular and Metabolic Risk
Original Research

Association of Intrauterine Exposure to Maternal Diabetes and Obesity With Type 2 Diabetes in Youth

The SEARCH Case-Control Study

Dana Dabelea, MD1, Elizabeth J. Mayer-Davis, PHD2, Archana P. Lamichhane, MD3, Ralph B. D'Agostino, Jr., MD4, Angela D. Liese, PHD3, Kendra S. Vehik, MD1, K.M. Venkat Narayan, MD5, Phillip Zeitler, MD6 and Richard F. Hamman, MD1

1 Department of Preventive Medicine and Biometrics, University of Colorado Denver, Denver, Colorado
2 Nutrition Department, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
3 Arnold School of Public Health, Columbia, South Carolina
4 Wake Forest University School of Medicine, Winston-Salem, North Carolina
5 The Rollins School of Public Health, Emory University, Atlanta, Georgia
6 Department of Pediatrics, University of Colorado Denver, Denver, Colorado

Corresponding author: Dana Dabelea, dana.dabelea{at}uchsc.edu

OBJECTIVE—Limited data exist on the association between in utero exposure to maternal diabetes and obesity and type 2 diabetes in diverse youth. These associations were explored in African-American, Hispanic, and non-Hispanic white youth participating in the SEARCH Case-Control Study.

RESEARCH DESIGN AND METHODS—A total of 79 youth with type 2 diabetes and 190 nondiabetic control youth aged 10–22 years attended a research visit. In utero exposures to maternal diabetes and obesity were recalled by biological mothers.

RESULTS—Youth with type 2 diabetes were more likely to have been exposed to maternal diabetes or obesity in utero than were nondiabetic control youth (P < 0.0001 for each). After adjusting for offspring age, sex, and race/ethnicity, exposure to maternal diabetes (odds ratio [OR] 5.7 [95% CI 2.4–13.4]) and exposure to maternal obesity (2.8 [1.5–5.2]) were independently associated with type 2 diabetes. Adjustment for other perinatal and socioeconomic factors did not alter these associations. When offspring BMI was added, the OR for the association between in utero exposure to obesity and type 2 diabetes was attenuated toward the null (OR 1.1 [0.5–2.4]). Overall, 47.2% (95% CI 30.9–63.5) of type 2 diabetes in youth could be attributed to intrauterine exposure to maternal diabetes and obesity.

CONCLUSIONS—Intrauterine exposures to maternal diabetes and obesity are strongly associated with type 2 diabetes in youth. Prevention efforts may need to target, in addition to childhood obesity, the increasing number of pregnancies complicated by obesity and diabetes.


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