Exposure to maternal diabetes during pregnancy appears to influence the development of type 2 diabetes in children, according to recent data from the TODAY trial.
Steven D. Chernausek, MD, from the department of pediatrics at the University of Oklahoma Health Sciences Center in Oklahoma City, and colleagues found that maternal diabetes was associated with earlier diagnosis of diabetes, poorer glycemic control, and decreased beta-cell function, with a significant effect on beta-cell function in young black patients and young Hispanic patients, but not young white patients.
“In conclusion, the impact of parental diabetes on offspring is evident even post-diagnosis in the adolescent with type 2 diabetes,” Dr Chernausek and colleagues wrote in their study. “The relationships are complex and likely mediated by both genetic and fetal environmental factors (eg, intrauterine hyperglycemia resulting in epigenetic changes) that influence beta-cell function.”
The researchers evaluated 632 young patients aged 10 years to 17 years who were diagnosed with type 2 diabetes before age 2 years. Among other measurements, patients underwent an oral glucose test, a test to determine HbA1c, and a test to determine beta-cell function.
They found that a patient’s mother having diabetes prior to pregnancy or gestational diabetes during pregnancy resulted in a patient being diagnosed with diabetes at an earlier age (average, 0.6 years younger).
HbA1c was increased by an average of 0.3%, resulting in dysglycemia at baseline, and beta-cell function was reduced in children exposed to maternal diabetes vs those who were not.
The researchers found no significant association between paternal diabetes and subsequent development of earlier diabetes in children.