Transgenerational Transmission of Non-communicable Diseases: How to Break the Vicious Cycle?

Abstract

Non-communicable diseases (NCDs) like diabetes, obesity, hypertension, and cardiovascular diseases are major causes of morbidity and mortality all over the world. In recent decades, NCDs are sweeping steadily across the globe much like a silent yet devastating pandemic. Among other factors, the rising trend in diabetes and related NCDs is also linked to hyperglycemia in pregnancy (HIP). Maternal hyperglycemia acts as an in-utero insult to the developing fetus making the offspring prone to develop NCDs in adulthood. Resistance to the hormones insulin and leptin in the offspring affects the metabolic milieu predisposing the individual to obesity and diabetes. Epigenetic processes like DNA methylation, genomic imprinting, and histone modifications are likely to be impacted in an in-utero environment influenced by maternal hyperglycemia. HIP affects not only the health of the mother and her offspring but also sets up adverse intra-uterine programming that leads to a vicious cycle of transgenerational transmission of obesity, insulin resistance, diabetes, and other related NCDS to future generations. The need to break this vicious cycle is much essential now, more than ever before. Children, adolescents, and young adults should be encouraged to maintain a healthy weight and adopt a healthy lifestyle. Preconception counseling should begin early for women with diabetes, with continued guidance throughout their reproductive years. This article highlights how targeting pregnancy-related diabetes to break the chain of transgenerational transmission of NCDs would be an effective action to bring down the increasing burden of NCDs.

Keywords: diabetes; in-utero programming; non-communicable disease; pregnancy; transgenerational transmission; vicious cycle.

Figure 1. Transgenerational transmission of diabetes – the vicious cycle.

From Dabelea and Crume (2011) [5], used under the Creative Commons license - http://creativecommons.org/licenses/by-nc-nd/3.0/.