Comparison of plasma insulin levels after a mixed-meal challenge in children with and without intrauterine exposure to diabetes.
BACKGROUND
The diabetic intrauterine environment is a known risk factor for the development of diabetes in the offspring.


OBJECTIVE
We compared anthropometric and metabolic characteristics of 41 nondiabetic children whose mothers developed diabetes either before (ODM, n = 19, 9.3 +/- 1.1 yr) or after (OPDM, n = 22, 9.5 +/- 1.3 yr) the pregnancy of interest. Maternal diabetes status was established from OGTT results before, during, and after the pregnancy of interest.


METHODS
After consuming a standardized diet for 2 d, a mixed-meal breakfast was given after an overnight fast. Fasting concentrations and responses of plasma glucose and insulin were evaluated using linear regression analyses to assess potential independent determinants of plasma insulin concentration at each time point.


RESULTS
After adjustment for age and sex, there were no differences between ODM and OPDM children for maternal age at diagnosis, height, weight, body mass index, BMI z score, or percent body fat (dual energy x-ray absorptiometry). After adjusting for age, sex, percent body fat, and the corresponding glucose level at each time point, ODM had a lower plasma insulin level at the 15-min time point during the meal test than OPDM (P = 0.01).


CONCLUSIONS
A lower initial insulin response to a standard mixed-meal challenge can be detected in nondiabetic ODM compared with OPDM children as early as 9 yr of age. This response may be another indicator for an attenuated early insulin response and explain the increased risk for diabetes in these children.
Salbe
A D
AD
NIH/NIDDK/Obesity and Diabetes Clinical Research Section, 4212 North 16th Street, Room 541, Phoenix, Arizona 85016, USA.
Lindsay
R S
RS
Collins
C B
CB
Tataranni
P A
PA
Krakoff
J
J
Bunt
J C
JC
D000328:Adult; D001786:Blood Glucose / Q000378:metabolism; D002648:Child; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology* / Q000209:etiology / Q000503:physiopathology; D004435:Eating / Q000502:physiology*; D005260:Female; D006801:Humans; D007198:Indians, North American / Q000706:statistics & numerical data; D007328:Insulin / Q000097:blood*; D007333:Insulin Resistance; D016014:Linear Models; D008297:Male; D011247:Pregnancy; D011254:Pregnancy in Diabetics / Q000453:epidemiology* / Q000503:physiopathology; D011297:Prenatal Exposure Delayed Effects; D012307:Risk Factors
D001786:Blood Glucose; D007328:Insulin