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. 2013 Sep;98(9):3793-801.
doi: 10.1210/jc.2013-1536. Epub 2013 Jun 24.

Insulin resistance and impaired pancreatic β-cell function in adult offspring of women with diabetes in pregnancy

Louise Kelstrup  1 , Peter Damm, Elisabeth R Mathiesen, Torben Hansen, Allan A Vaag, Oluf Pedersen, Tine D Clausen
Affiliations

Insulin resistance and impaired pancreatic β-cell function in adult offspring of women with diabetes in pregnancy

Louise Kelstrup et al. J Clin Endocrinol Metab. 2013 Sep.

Abstract

Context: Offspring of women with diabetes during pregnancy have an increased risk of glucose intolerance in adulthood, but the underlying mechanisms are unknown.

Objective: We aimed to investigate the effects of intrauterine hyperglycemia on insulin secretion and action in adult offspring of mothers with diabetes.

Design, setting, and participants: A cohort of 587 Caucasian offspring, without known diabetes, was followed up at the age of 18-27 years. We included 2 groups exposed to maternal diabetes in utero: offspring of women with gestational diabetes mellitus (n = 167) or type 1 diabetes (n = 153). Two reference groups were included: offspring of women with risk factors for gestational diabetes mellitus but normoglycemia during pregnancy (n = 139) and offspring from the background population (n = 128).

Main outcome measures: Indices of insulin sensitivity and insulin release were calculated using insulin and glucose values from a standard oral glucose tolerance test (120 minutes, 75 g glucose). Pancreatic β-cell function taking the prevailing insulin sensitivity into account was estimated by disposition indices.

Results: Both groups of offspring exposed during pregnancy to either maternal gestational diabetes or type 1 diabetes had reduced insulin sensitivity compared with offspring from the background population (both P < .005). We did not find any significant difference in absolute measures of insulin release. However, the disposition index was significantly reduced in both the diabetes-exposed groups (both P < .005).

Conclusion: Reduced insulin sensitivity as well as impaired pancreatic β-cell function may contribute to the increased risk of glucose intolerance among adult offspring born to women with diabetes during pregnancy.

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Figures

Figure 1.
Figure 1.
Study design: flow chart of subjects participating in the study (n = 587) and subjects lost to follow-up (n = 469) or excluded due to previously known type 1 or type 2 diabetes (n = 10). O-GDM included offspring of mothers with gestational diabetes (GDM); O-Type1 included offspring of mothers with type 1 diabetes; O-NoGDM included offspring of mothers with risk factors for GDM, but normoglycemic in pregnancy; O-BP included offspring of mothers from the background population without risk factors for diabetes.
Figure 2.
Figure 2.
Calculations of estimates.
See this image and copyright information in PMC

Comment in

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