CHICAGO – Children born to mothers with type 1 diabetes have a three times higher risk of developing type 2 diabetes as adults, according to a Danish cohort study that followed a group of adult individuals born to diabetic mothers.
The study also showed that the same individuals, who ranged in age from 18 years to 27 years, had more than twice the risk of being overweight and almost three times the risk of having metabolic syndrome, Dr. Tine D. Clausen said at the annual scientific sessions of the American Diabetes Association.
The study adds to a growing body of literature suggesting diabetes begets more diabetes, though most previous studies have investigated children born to mothers who were overweight or had type 2 diabetes.
“In the offspring born to women with type 1 diabetes, we found an association between median maternal glucose in late pregnancy and offspring risk of type 2 diabetes or prediabetes,” said Dr. Clausen, of the department of obstetrics, Rigshospitalet, Copenhagen. Her group studied 160 adults born to mothers with type 1 diabetes between 1978 and 1985, and matched them to a group of 128 similar-aged adults born to mothers without type 1 diabetes.
In the two groups, the prevalence of type 2 diabetes was 11% in the subjects born to mothers with diabetes, compared with 4% in the control group. Of the diabetic-mother subjects, 41% were overweight (a body mass index [kg/m
An additional 9% of the subjects born to diabetic mothers had impaired glucose regulation–either a high fasting glucose, or an abnormal oral glucose tolerance test result–compared with 3% of the controls.
Offspring of mothers with type 1 diabetes also were more likely to be born prematurely, to have a lower gestational age, and to be large for gestational age. Moreover, the mean hemoglobin A1c level was higher in the offspring of the mothers with type 1 diabetes (5.0% vs. 4.8%).
The groups were similar in having a family history (other than the mother) of diabetes, in the percentage of mothers who were overweight before pregnancy, and in the mother's age at delivery. They differed in that a greater proportion of the children born to mothers with diabetes were of “lower social class,” Dr. Clausen said.
After statistical adjustments for age, maternal overweight status, and social class, the researchers found that the odds ratio of the diabetic offspring having prediabetes or type 2 diabetes was 3.3, of being overweight was 2.1, and of having the metabolic syndrome was 2.8, she said. Adjusting the statistical model for preterm birth made no difference in those odds ratios.
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