Association Between Maternal Diabetes in Utero and Age at Offspring's Diagnosis of Type 2 Diabetes
- David J. Pettitt, MD1,
- Jean M. Lawrence, SCD, MPH, MSSA2,
- Jennifer Beyer, MS3,
- Teresa A. Hillier, MD, MS4,
- Angela D. Liese, PHD, MPH5,
- Beth Mayer-Davis, PHD6,
- Beth Loots, MPH, MSW7,
- Giuseppina Imperatore, MD, PHD8,
- Lenna Liu, MD, MPH9,
- Lawrence M. Dolan, MD10,
- Barbara Linder, MD, PHD11 and
- Dana Dabelea, MD, PHD12
- 1Sansum Diabetes Research Institute, Santa Barbara, California
- 2Kaiser Permanente Southern California, Pasadena, California
- 3Wake Forest University School of Medicine, Winston-Salem, North Carolina
- 4Kaiser Permanente Center for Health Research Northwest/Hawaii, Honolulu, Hawaii
- 5Department of Epidemiology and Biostatistics and Center for Research in Nutrition and Health Disparities, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
- 6University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
- 7Seattle Children's Hospital and Regional Medical Center, Seattle, Washington
- 8Centers for Disease Control and Prevention, Atlanta, Georgia
- 9University of Washington, Seattle, Washington
- 10Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
- 11National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland
- 12University of Colorado, Denver, Colorado
- Corresponding author: David Pettitt, dpettitt{at}sansum.org
Abstract
OBJECTIVE—The purpose of this study was to examine age of diabetes diagnosis in youth who have a parent with diabetes by diabetes type and whether the parent's diabetes was diagnosed before or after the youth's birth.
RESEARCH DESIGN AND METHODS—The cohort comprised SEARCH for Diabetes in Youth Study participants (diabetes diagnosis 2001–2005) with a diabetic parent. SEARCH is a multicenter survey of youth with diabetes diagnosed before age 20 years.
RESULTS—Youth with type 2 diabetes were more likely to have a parent with either type 1 or type 2 diabetes (mother 39.3%; father 21.2%) than youth with type 1 diabetes (5.3 and 6.7%, respectively, P < 0.001 for each). Type 2 diabetes was diagnosed 1.68 years earlier among those exposed to diabetes in utero (n = 174) than among those whose mothers’ diabetes was diagnosed later (P = 0.018, controlled for maternal diagnosis age, paternal diabetes, sex, and race/ethnicity). Age at diagnosis of type 1 diabetes for 269 youth with and without in utero exposure did not differ significantly (difference 0.96 year, P = 0.403 after adjustment). Controlled for the father's age of diagnosis, father's diabetes before the child's birth was not associated with age at diagnosis (P = 0.078 for type 1 diabetes; P = 0.140 for type 2 diabetes).
CONCLUSIONS—Type 2 diabetes was diagnosed at younger ages among those exposed to hyperglycemia in utero. Among youth with type 1 diabetes, the effect of the intrauterine exposure was not significant when controlled for mother's age of diagnosis. This study helps explain why other studies have found higher age-specific rates of type 2 diabetes among offspring of women with diabetes.
Footnotes
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Published ahead of print at http://care.diabetesjournals.org on 11 August 2008.
The contents of this article are solely the responsibility of the authors and do not necessarily represent the official views of the Centers for Disease Control and Prevention.
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- Accepted July 31, 2008.
- Received April 22, 2008.
- DIABETES CARE
