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Maternal Diabetes Increases Risk for Type 2 Diabetes Children

Exposure to diabetes in utero may significantly impair beta-cell function in children…. 

Steven D. Chernausek, MD, associate chief of the pediatric diabetes and endocrinology section, the University of Oklahoma College of Medicine stated that, "We found that if the child is born to a mother with diagnosis either before or during the pregnancy, that child presented at a younger age with a diagnosis of diabetes, had measurable deterioration in glucose control, higher blood glucose on oral glucose tolerance tests, had higher HbA1c, and that this was all due to an effect on beta-cell function, not on insulin sensitivity."

"What we found was that the impact of the mother’s diabetes on the beta cell was only apparent in non-Hispanic blacks and Hispanics. It wasn’t apparent in Caucasians, and that was a surprising finding."

The TODAY study, a large well-controlled study looking at young, well-controlled adolescents with diabetes, was used in this analysis to look specifically at the effect on those patients born to women with diabetes in pregnancy.

Children born to mothers with diabetes had higher HbA1c and fasting blood glucose at baseline (P<.0001), and C-peptide index and oral disposition index, both of which were used as measures of beta-cell function, were decreased (P≤.0001). Pair-wise comparisons showed these effects were only present in non-Hispanic black and Hispanic participants (all P<.01).

Chernausek added that, "We’ve known for a long time there’s differences in diabetes in Caucasians compared to Hispanics; there are differences of metabolic control." "This is another sign that type 2 diabetes is different in the Hispanic, non-Hispanic black populations. It manifests in different ways and they’re susceptible to different things."

Practice Pearls:
  • Type 2 diabetes in utero significantly impairs beta-cell function in children.
  • The results of this study are preliminary and no conclusions should be made until it has been reviewed and published.
  • Type 2 diabetes is different in the Hispanic, non-Hispanic black populations.

Presented at: the Pediatric Academic Societies and Asian Society for Pediatric Research joint meeting; May 3-6, 2014; Vancouver, British Columbia.