Follow‐up of Children of Insulin Dependent (Type I) and Gestational Diabetic Mothers

Persson, Bengt; Gentz, J.; Möller, Erna

doi:10.1111/j.1651-2227.1984.tb17775.x

Cited by 28 publications

(19 citation statements)

References 15 publications

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“…At all ages, IGDM displayed higher glucose values than IDM while IDM had elevated levels of insulin. These results seem to be in contrast to observations of Persson et al [14] who observed similar glucose disappearance rates and insulin levels in IDM and IGDM at 5 years of age. However, a tendency towards higher insulin values was also visible in their IDM group.…”

Section: Discussioncontrasting

confidence: 56%

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Glucose tolerance and insulin secretion in children of mothers with pregestational IDDM or gestational diabetes

et al. 1997

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Since Pedersen's fundamental work [1] the metabolic situation in infants of mothers with diabetes mellitus during pregnancy has been investigated in a number of studies [2][3][4]. While most authors focussed on altered glucose homeostasis during neonatal life, it remains unclear if these alterations do persist or resolve in later life. Clinical investigations during childhood indicated elevated frequencies of impaired glucose tolerance (IGT) in the offspring of mothers with diabetes during pregnancy [5,6]. Some authors reported alterations of insulin secretion such as hyperinsulinaemia [6,7] which is known to play a key role in the development of metabolic and cardiovascular disturbances in adulthood [8]. Experimental studies in rats displayed long-term alterations of glucose tolerance and insulin secretion due to the induction of maternal gestational hyperglycaemia which leads to fetal and neonatal hyperinsulinism [9][10][11][12][13].However, only a very small number of studies are available which compared glucose metabolism and Diabetologia (1997Diabetologia ( ) 40: 1094Diabetologia ( -1100 Glucose tolerance and insulin secretion in children of mothers with pregestational IDDM or gestational diabetes Summary The offspring of mothers with diabetes mellitus during pregnancy are presumed to develop altered glucose homeostasis. We analysed metabolic parameters at birth and glucose tolerance and insulin secretion during oral glucose tolerance tests at 1-9 years of age in 129 children born to mothers with pregestational insulin-dependent diabetes (IDDM) and 69 infants of gestational diabetic mothers. Newborns of IDDM mothers displayed higher insulin (p < 0.001), glucose (p < 0.05), and insulin/glucose ratios (p < 0.002) than newborns of gestational diabetic mothers. During childhood, frequencies of impaired glucose tolerance (IGT) rose in infants of IDDM mothers from 9.4 % at 1-4 years to 17.4 % at 5-9 years of age, while in children of gestational diabetic mothers an increase from 11.1 % up to 20.0 % was observed. Offspring of gestational diabetic mothers displayed higher stimulated blood glucose (p < 0.025) than infants of IDDM mothers, while children of IDDM mothers showed higher stimulated insulin (p < 0.025), accompanied by increased fasting and stimulated insulin/glucose ratios (p < 0.05 and p < 0.02, respectively). Stimulated insulin in childhood was positively correlated to insulin at birth (p < 0.05). Furthermore, insulin/glucose ratio in childhood showed a positive correlation to insulin (p < 0.01) and insulin/glucose ratio at birth (p < 0.005). In conclusion, a pathogenetic role of fetal and neonatal hyperinsulinism for the development of IGT in both groups of infants of diabetic mothers is suggested, in particular for early induction of insulin resistance in the offspring of mothers with pregestational IDDM. [Diabetologia (1997)

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Section: Discussioncontrasting

confidence: 56%

“…insulin secretion in infants of mothers suffering from pregestational insulin-dependent diabetes mellitus (IDDM) with those born to mothers with gestational diabetes [14]. Therefore, the aim of this study was to compare features of glucose metabolism and insulin secretion in these children and with regard to the initial situation at birth.…”

Section: Discussionmentioning

confidence: 99%

Glucose tolerance and insulin secretion in children of mothers with pregestational IDDM or gestational diabetes

et al. 1997

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“…All previous studies of childhood obesity in the offspring of mothers with GDM also have included mothers with known IDDM 12,14,15,35 or NIDDM. 13 A Swedish study, the only to report results separately for offspring of mothers with GDM, showed no association between GDM and childhood obesity.…”

Section: Discussionmentioning

confidence: 99%

Gestational Diabetes and the Risk of Offspring Obesity

et al. 1998

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ABSTRACT. Background. Intrauterine exposure to the metabolic alterations of maternal diabetes may increase the risk of later obesity. We determined whether offspring of mothers with diet-treated, gestational diabetes mellitus (GDM) have an increased risk of childhood obesity and examined the relationship between childhood obesity and metabolic markers of GDM.Methods. At a health maintenance organization in Seattle, WA, we reviewed medical records to obtain the life-time height and weight measurements of 524, 8-to 10-year-old children whose mothers had been screened for GDM. Maternal plasma glucose and triglyceride levels were obtained in midgestation 1 hour after ingestion of 50 g of glucose. Those with glucose screening levels >7.77 mmol/L (140 mg/dL) underwent a 3-hour, 100-g, oral glucose tolerance test to determine GDM status. Cord serum insulin levels also were obtained at birth. Obesity was defined as an average body mass index between 5 and 10 years of age at or above the 85th percentile for age and sex.Results. The prevalence of obesity was 19% in the 58 offspring of mothers with diet-treated GDM and 24% in the 257 offspring of mothers with negative glucose screen values. There also was no difference in mean body mass index (adjusted for age and sex) between these two groups of offspring. Among all 524 offspring, there was no significant increase in the rate of offspring obesity according to the quartile of maternal screening glucose, triglyceride, oral glucose tolerance test, or cord serum insulin level.Conclusion. Prenatal exposure to the metabolic effects of mild, diet-treated GDM does not increase the risk of childhood obesity. Pediatrics 1998;101(2). URL: http:// www.pediatrics.org/cgi/content/full/101/2/e9; pregnancy in diabetes, obesity, fetus, child, body mass index.ABBREVIATIONS. IDDM, insulin-dependent diabetes mellitus; GDM, gestational diabetes mellitus; NIDDM, noninsulin-dependent diabetes mellitus; GHC, Group Health Cooperative of Puget Sound; HMO, health maintenance organization; OGTT, oral glucose tolerance test; BMI, body mass index. C hildren born to mothers with insulin-dependent diabetes mellitus (IDDM) have an increased risk of later obesity.1-5 These children may be programmed in utero for later obesity by exposure to excess metabolic substrate at a sensitive period in development.6 -8 Gestational diabetes mellitus (GDM), that is, diabetes with onset or first recognition during pregnancy, 9 affects 3% to 5% of all pregnancies.10,11 GDM is far more common in pregnant women than is existing IDDM or noninsulindependent diabetes mellitus (NIDDM). Previous studies suggest that GDM also increases the risk for later obesity in the offspring.12-15 Each of these studies, however, contained a mixture of subjects with GDM and either IDDM or NIDDM. No study has ever compared childhood obesity rates in offspring of mothers with and without GDM. Therefore, we tested the hypothesis that offspring from pregnancies affected by GDM have an increased risk of childhood obesity. To suggest a possible me...

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“…There is some evidence that the offspring of women with pre-gestational type 1 diabetes (PGDM), the archetypal adverse intrauterine environment, are at risk of developing glucose intolerance and cardiovascular disease in young childhood and adolescence [4][5][6][7][8][9][10]. The reason(s) for these observations are unknown, but the literature has emphasised nutritional or genetic models of pre-programming [1][2][3].…”

Section: Introductionmentioning

confidence: 99%

Absence of telomere shortening and oxidative DNA damage in the young adult offspring of women with pre-gestational type 1 diabetes

et al. 2008

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Aims/hypothesis The offspring of mothers with pre-gestational type 1 diabetes (PGDM) may be at increased risk of glucose intolerance and cardiovascular disease in childhood. The underlying causes of these observations, and whether they persist into adulthood, are unknown. The aim of the present study was to test the hypothesis that fetal chromosomal telomere oxidative DNA damage resulting from maternal PGDM programmes the offspring towards a senescent phenotype that is detectable in young adulthood. Methods We studied 21 young adult offspring (age 16-23 years) with a maternal history of PGDM and 23 age-and weight-matched controls with no maternal history of diabetes. All participants underwent anthropometric assessments, a standard 75 g OGTT, measurement of peripheral blood mononuclear cell and skin fibroblast telomere length, fibroblast senescence, cell DNA damage (by determination of 8-oxoguanine levels using flow cytometry), plasma lipoprotein profiles (determined by nuclear magnetic resonance) and plasma levels of soluble adhesion molecules and inflammatory markers. ResultsThe groups did not differ significantly with respect to anthropometric measures, glucose tolerance, fasting and 2 h plasma insulin levels during OGTT, estimated peripheral insulin resistance, peripheral blood mononuclear cell or fibroblast telomere length, DNA damage or senescence in vitro, plasma NMR lipoprotein profiles or levels of highsensitivity C-reactive protein. Plasma concentrations of soluble intercellular adhesion molecule 1 (sICAM-1; p< 0.05) and IL-6 (p=0.08) were higher in the PGDM offspring. Conclusions/interpretation Young adult offspring of mothers with PGDM do not differ in terms of glucose tolerance, DNA damage or telomere length from controls of the same weight and BMI. This does not preclude such abnormalities at an earlier age, but there is no evidence of telomere damage as a pre-programming mechanism in the young adults enrolled in this study.

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Follow‐up of Children of Insulin Dependent (Type I) and Gestational Diabetic Mothers

Cited by 28 publications

References 15 publications

Glucose tolerance and insulin secretion in children of mothers with pregestational IDDM or gestational diabetes

Glucose tolerance and insulin secretion in children of mothers with pregestational IDDM or gestational diabetes

Gestational Diabetes and the Risk of Offspring Obesity

Absence of telomere shortening and oxidative DNA damage in the young adult offspring of women with pre-gestational type 1 diabetes

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