Association between Maternal Diabetes In Utero and Age of Offspring's Diagnosis with Type 2 Diabetes

  1. David J. Pettitt, MD (dpettitt{at}sansum.org)1,
  2. Jean M. Lawrence, ScD, MPH, MSSA2,
  3. Jennifer Beyer, MS3,
  4. Teresa A. Hillier, MD, MS4,
  5. Angela D. Liese, PhD, MPH5,
  6. Beth Mayer-Davis, PhD6,
  7. Beth Loots, MPH, MSW7,
  8. Giuseppina Imperatore, MD, PhD8,
  9. Lenna Liu, MD, MPH9,
  10. Lawrence M. Dolan, MD10,
  11. Barbara Linder, MD, PhD11 and
  12. Dana Dabelea, MD, PhD12
  1. 1Sansum Diabetes Research Institute, Santa Barbara, CA
  2. 2Kaiser Permanente Southern California, Pasadena CA
  3. 3Wake Forest University School of Medicine, Winston-Salem, NC
  4. 4Kaiser Permanente Center for Health Research Northwest/Hawaii, Honolulu, HI
  5. 5Department of Epidemiology and Biostatistics and Center for Research in Nutrition and Health Disparities, Arnold School of Public Health, University of South Carolina, Columbia, SC
  6. 6University of North Carolina at Chapel Hill, Chapel Hill, NC
  7. 7Seattle Children's Hospital and Regional Medical Center, Seattle WA
  8. 8Centers for Disease Control and Prevention, Atlanta GA
  9. 9University of Washington, Seattle WA
  10. 10Cincinnati Children's Hospital Medical Center, Cincinnati OH
  11. 11National Institute of Diabetes and Digestive and Kidney Diseases, NIH, Bethesda MD
  12. 12University of Colorado, Denver CO

    Abstract

    Objective— 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— 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 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 years, 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; p=0.140 for type 2).

    Conclusions— Type 2 diabetes was diagnosed at younger ages among those exposed to hyperglycemia in utero. Among youth with type 1 diabetes, when controlled for the mother's age of diagnosis, the effect of the intrauterine exposure was not significant. This study helps explain why other studies have found higher age-specific rates of type 2 diabetes among offspring of women with diabetes.

    Footnotes

      • Received April 22, 2008.
      • Accepted July 31, 2008.

    This Article

    1. Published online before print August 11, 2008, doi: 10.2337/dc08-0769
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