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

  1. Tine D. Clausen, MD1,
  2. Elisabeth R. Mathiesen, MD, DMSC2,
  3. Torben Hansen, MD, PHD3,
  4. Oluf Pedersen, MD, DMSC3,
  5. Dorte M. Jensen, MD, PHD4,
  6. Jeannet Lauenborg, MD, PHD1 and
  7. Peter Damm, MD, DMSC1
  1. 1Department of Obstetrics, Copenhagen Center for Pregnant Women with Diabetes, Copenhagen University Hospital, Rigshospitalet, Denmark
  2. 2Department of Endocrinology, Copenhagen University Hospital, Rigshospitalet, Denmark
  3. 3Steno Diabetes Center, Copenhagen, Denmark
  4. 4Department of Endocrinology, Odense University Hospital, Odense, Denmark
  1. Address correspondence and reprint requests to Tine Dalsgaard Clausen, MD, Department of Obstetrics 4031, Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen, Denmark. E-mail: tine.dalsgaard.clausen{at}dadlnet.dk

Abstract

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.

Footnotes

  • Published ahead of print at http://care.diabetesjournals.org on 13 November 2007. DOI: 10.2337/dc07-1596.

    Additional information for this article can be found in an online appendix available at http://dx.doi.org/10.2337/dc07-1596.

    The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked “advertisement” in accordance with 18 U.S.C Section 1734 solely to indicate this fact.

    • Accepted November 6, 2007.
    • Received August 13, 2007.
« Previous | Next Article »Table of Contents

This Article

  1. Published online before print November 13, 2007, doi: 10.2337/dc07-1596 Diabetes Care February 2008 vol. 31 no. 2 340-346
  1. » Abstract
  2. Full Text
  3. Full Text (PDF)
  4. Online-Only Appendix
  5. All Versions of this Article:
    1. dc07-1596v1
    2. 31/2/340 most recent

Current Issue

  1. November 2009, 32 (11)
  1. Current Issue
  1. Alert me to new issues of Diabetes Care