Maternal type 1 and gestational diabetes: postnatal differences in insulin secretion in offspring at preschool age.
BACKGROUND
It is well known that children born to mothers with diabetes in pregnancy are more likely to develop metabolic abnormalities in later life. Most prior studies have not differentiated between offspring of mothers with type 1 diabetes (T1DM) and gestational diabetes (GDM) or lack a control group of non-exposed offspring.


METHODS
Offspring of T1DM (n = 16), GDM (n = 22) and mothers without diabetes (n = 25) born at Oulu University Hospital.


OBJECTIVE
To assess insulin secretion and insulin resistance in the offspring of T1DM and GDM at preschool age in comparison with offspring of non-diabetic mothers.


METHODS
Anthropometric measurements and intravenous glucose tolerance testing were performed. First-phase insulin response (FPIR) and homoeostasis model assessment (HOMA) values were calculated. Pregnancy and birth data were analysed in relation to later metabolic parameters in all three groups using one-way analysis of variance (ANOVA) and analysis of covariance (ANCOVA).


RESULTS
At a mean age of 4.9 yr, offspring of T1DM had increased fasting serum insulin concentrations (p = 0.044), FPIR (p = 0.034) and HOMA-B values (p = 0.008) compared with offspring of GDM or with offspring of healthy controls (statistically non-significant). The GDM gained least weight during pregnancy, and when adjusted for maternal weight gain during pregnancy, there were no statistically significant differences between study groups.


CONCLUSIONS
Prenatal exposures to maternal type 1 and gestational diabetes may have different effects on postnatal glucose metabolism in the offspring assessed at a mean age close to 5 yr. Maternal weight gain in pregnancy may affect the postnatal glucose metabolism in the offspring.
Department of Obstetrics and Gynaecology, Oulu University Hospital, Oulu, Finland. jatta.pirkola@gmail.com
Jatta
J
Pirkola
Marja
M
Vääräsmäki
Erja
E
Leinonen
Aini
A
Bloigu
Riitta
R
Veijola
Päivi
P
Tossavainen
Mikael
M
Knip
Päivi
P
Tapanainen
D000328:Adult; D001786:Blood Glucose / Q000378:metabolism; D002675:Child, Preschool; D003922:Diabetes Mellitus, Type 1 / Q000503:physiopathology*; D016640:Diabetes, Gestational / Q000503:physiopathology*; D005260:Female; D005951:Glucose Tolerance Test; D006706:Homeostasis; D006801:Humans; D007328:Insulin / Q000097:blood / Q000378:metabolism*; D007333:Insulin Resistance; D000078790:Insulin Secretion; D008297:Male; D009035:Mothers; D011247:Pregnancy; D011254:Pregnancy in Diabetics / Q000503:physiopathology*; D011297:Prenatal Exposure Delayed Effects / Q000503:physiopathology*; D011446:Prospective Studies
D001786:Blood Glucose; D007328:Insulin