Intrauterine exposure to maternal diabetes is associated with higher adiposity and insulin resistance and clustering of cardiovascular risk markers in Indian children

OBJECTIVE — To test the hypothesis that maternal gestational diabetes increases cardiovas-cular risk markers in Indian children. RESEARCH DESIGN AND METHODS — Anthropometry, blood pressure, and glu-cose/insulin concentrations were measured in 514 children at 5 and 9.5 years of age (35 offspring of diabetic mothers [ODMs], 39 offspring of diabetic fathers [ODFs]). Children of nondiabetic parents were control subjects. RESULTS — At age 9.5 years, female ODMs had larger skinfolds (P 0.001), higher glucose (30 min) and insulin concentrations, and higher homeostasis model assessment (HOMA) of insulin resistance and systolic blood pressure (P 0.05) than control subjects. Male ODMs had higher HOMA (P 0.01). Associations were stronger than at age 5 years. Female ODFs had larger skinfolds and male ODFs had higher HOMA (P 0.05) than control subjects; associations were weaker than for ODMs. Associations between outcomes in control subjects and parental BMI, glucose, and insulin concentrations were similar for mothers and fathers. CONCLUSIONS — The intrauterine environment experienced by ODMs increases diabetes and cardiovascular risk over genetic factors; the effects strengthen during childhood. Diabetes Care 33:402–404, 2010 O ffspring of diabetic mothers (ODMs)are at an increased risk for obesity/adiposity, glucose intolerance, and increased blood pressure even during childhood (1–4). These risks are higher compared with offspring of diabetic fa-thers (ODFs), suggesting intrauterine programming by maternal hyperglycemia (1). Even in nondiabetic pregnancies, higher maternal glycaemia is associated with neonatal and postnatal adiposity (5,6). In a cohort of 5-year-old Indian children, maternal gestational diabetes (GDM), but not paternal diabetes, was associated with increased adiposity and insulin concentrations in the female off-spring (7). The children were reexamined at 9–10 years of age