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.
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.


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.
Clausen
Tine D
TD
Department of Obstetrics, Copenhagen Center for Pregnant Women with Diabetes, Copenhagen University Hospital, Rigshospitalet, Denmark. tine.dalsgaard.clausen@dadlnet.dk
Mathiesen
Elisabeth R
ER
Hansen
Torben
T
Pedersen
Oluf
O
Jensen
Dorte M
DM
Lauenborg
Jeannet
J
Damm
Peter
P
D000328:Adult; D003718:Denmark / Q000453:epidemiology; D003922:Diabetes Mellitus, Type 1 / Q000453:epidemiology*; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology* / Q000235:genetics; D016640:Diabetes, Gestational / Q000453:epidemiology*; D005260:Female; D020022:Genetic Predisposition to Disease; D005951:Glucose Tolerance Test; D006801:Humans; D006943:Hyperglycemia / Q000150:complications*; D050177:Overweight / Q000097:blood; D011236:Prediabetic State / Q000453:epidemiology* / Q000235:genetics; D011247:Pregnancy; D011248:Pregnancy Complications / Q000097:blood* / Q000453:epidemiology; D012044:Regression Analysis; D012907:Smoking / Q000453:epidemiology