Children exposed to gestational diabetes in utero are about six times more likely to develop diabetes or prediabetes compared with those not exposed, according to recent study findings published in Diabetologia.
Sonia Caprio, MD, of the department of pediatrics at the Yale University School of Medicine, and colleagues evaluated 255 obese adolescents with normal glucose tolerance to determine the effect of exposure to gestational diabetes while in the womb on the risk for diabetes and prediabetes.
Overall, 82.3% of all participants were not exposed to gestational diabetes.
Of those, 91% had normal glucose tolerance at follow-up, whereas 8.6% developed impaired glucose tolerance or diabetes. Nearly 69% of the group exposed had normal glucose tolerance at follow-up, whereas 31.1% developed IGT or diabetes.
At follow-up, 84% of the not-exposed group had normal fasting glucose, and 16% had impaired fasting glucose. Normal fasting glucose was maintained in 71% of the exposed group, and 29% had IFG. Of note, 12 participants with type 2 diabetes or IGT also had IFG at follow-up.
“Offspring of [gestational diabetes mellitus] mothers ought to be screened for IGT and/or impaired fasting glucose (another form of prediabetes), and preventive and therapeutic strategies should be considered before the development of full clinical manifestation of diabetes,” the researchers wrote. “While we cannot use this analysis for development of definitive screening guidelines, we strongly suggest that, among obese children and adolescents exposed to [gestational diabetes mellitus], specifically if additional risk factors are present — such as severe obesity or being of ethnicity minorities at higher risk — oral glucose tolerance tests should be performed at baseline (specifically in mid-pubertal adolescents) and potentially repeated based on clinical judgment. Furthermore, the need for studies aimed at unraveling the role of genetic or epigenetic factors and environmental postnatal factors that might be causing functional defects in the beta cells has never been more urgent.”
Disclosure: See the full study for a complete list of the researchers’ relevant financial disclosures.