Determinants of Insulin Resistance in Infants at Age 1 Year Impact of gestational diabetes mellitus

OBJECTIVEdThe offspring of women with gestational diabetes mellitus (GDM) display a propensity for the early accrual of cardiometabolic risk factors, including insulin resistance, in childhood and adolescence. Thus, we sought to identify early life determinants of insulin re-sistance in infants of women with and without GDM. RESEARCH DESIGN ANDMETHODSdIn total, 104 full-term, singleton infants born to women with (n = 36) and without (n = 68) GDM were evaluated at age 1 year, with insulin resistance assessed by homeostasis model (HOMA-IR). RESULTSdHOMA-IR at 1 year did not differ between infants born to mothers with and without GDM (P = 0.74). The sole independent predictor of infant HOMA-IR in the non-GDM group was birth weight (t = 3.33, P = 0.002). In contrast, weight gain in the 1st year was the only independent predictor of HOMA-IR in infants of women with GDM (t = 2.19, P = 0.039). CONCLUSIONSdIn the 1st year of life, weight gain in infants born to women with GDM is associated with insulin resistance, unlike in their peers. The offspring of women with gesta-tional diabetes mellitus (GDM) ex-hibit a propensity for the early accrual of cardiometabolic risk factors in child