TY - JOUR
T1 - Hyperglycemia and adverse Pregnancy Outcome follow-up study (HAPO FUS)
T2 - Maternal gestational diabetes mellitus and childhood glucose metabolism
AU - on behalf of the HAPO Follow-up Study Cooperative Research Group
AU - Lowe, William L.
AU - Scholtens, Denise M.
AU - Kuang, Alan
AU - Linder, Barbara
AU - Lawrence, Jean M.
AU - Lebenthal, Yael
AU - McCance, David
AU - Hamilton, Jill
AU - Nodzenski, Michael
AU - Talbot, Octavious
AU - Brickman, Wendy J.
AU - Clayton, Peter
AU - Ma, Ronald C.
AU - Tam, Wing Hung
AU - Dyer, Alan R.
AU - Catalano, Patrick M.
AU - Lowe, Lynn P.
AU - Metzger, Boyd E.
N1 - Publisher Copyright:
© 2019 by the American Diabetes Association.
PY - 2019/3/1
Y1 - 2019/3/1
N2 - OBJECTIVE Whether hyperglycemia in utero less than overt diabetes is associated with altered childhood glucose metabolism is unknown. We examined associations of gestational diabetes mellitus (GDM) not confounded by treatment with childhood glycemia in the Hyperglycemia and Adverse Pregnancy Outcome (HAPO) cohort. RESEARCH DESIGN AND METHODS HAPO Follow-up Study (FUS) included 4,160 children ages 10–14 years who completed all or part of an oral glucose tolerance test (OGTT) and whose mothers had a 75-g OGTT at ∼28 weeks of gestation with blinded glucose values. The primary predictor was GDM by World Health Organization criteria. Child outcomes were impaired fasting glucose (IFG), impaired glucose tolerance (IGT), and type 2 diabetes. Additional measures included insulin sensitivity and secretion and oral disposition index. RESULTS For mothers with GDM, 10.6% of children had IGT compared with 5.0% of children of mothers without GDM; IFG frequencies were 9.2% and 7.4%, respectively. Type 2 diabetes cases were too few for analysis. Odds ratios (95% CI) adjusted for family history of diabetes, maternal BMI, and child BMI z score were 1.09 (0.78–1.52) for IFG and 1.96 (1.41–2.73) for IGT. GDM was positively associated with child’s 30-min, 1-h, and 2-h but not fasting glucose and inversely associated with insulin sensitivity and oral disposition index (adjusted mean difference 276.3 [95% CI 2130.3 to 222.4] and 20.12 [20.17 to 20.064]), respectively, but not insulinogenic index. CONCLUSIONS Offspring exposed to untreated GDM in utero are insulin resistant with limited b-cell compensation compared with offspring of mothers without GDM. GDM is significantly and independently associated with childhood IGT.
AB - OBJECTIVE Whether hyperglycemia in utero less than overt diabetes is associated with altered childhood glucose metabolism is unknown. We examined associations of gestational diabetes mellitus (GDM) not confounded by treatment with childhood glycemia in the Hyperglycemia and Adverse Pregnancy Outcome (HAPO) cohort. RESEARCH DESIGN AND METHODS HAPO Follow-up Study (FUS) included 4,160 children ages 10–14 years who completed all or part of an oral glucose tolerance test (OGTT) and whose mothers had a 75-g OGTT at ∼28 weeks of gestation with blinded glucose values. The primary predictor was GDM by World Health Organization criteria. Child outcomes were impaired fasting glucose (IFG), impaired glucose tolerance (IGT), and type 2 diabetes. Additional measures included insulin sensitivity and secretion and oral disposition index. RESULTS For mothers with GDM, 10.6% of children had IGT compared with 5.0% of children of mothers without GDM; IFG frequencies were 9.2% and 7.4%, respectively. Type 2 diabetes cases were too few for analysis. Odds ratios (95% CI) adjusted for family history of diabetes, maternal BMI, and child BMI z score were 1.09 (0.78–1.52) for IFG and 1.96 (1.41–2.73) for IGT. GDM was positively associated with child’s 30-min, 1-h, and 2-h but not fasting glucose and inversely associated with insulin sensitivity and oral disposition index (adjusted mean difference 276.3 [95% CI 2130.3 to 222.4] and 20.12 [20.17 to 20.064]), respectively, but not insulinogenic index. CONCLUSIONS Offspring exposed to untreated GDM in utero are insulin resistant with limited b-cell compensation compared with offspring of mothers without GDM. GDM is significantly and independently associated with childhood IGT.
UR - http://www.scopus.com/inward/record.url?scp=85061937125&partnerID=8YFLogxK
U2 - 10.2337/dc18-1646
DO - 10.2337/dc18-1646
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C2 - 30655380
AN - SCOPUS:85061937125
SN - 0149-5992
VL - 42
SP - 372
EP - 380
JO - Diabetes Care
JF - Diabetes Care
IS - 3
ER -