Hyperglycemia and adverse Pregnancy Outcome follow-up study (HAPO FUS)

Maternal gestational diabetes mellitus and childhood glucose metabolism

on behalf of the HAPO Follow-up Study Cooperative Research Group*

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

OBJECTIVE Whether hyperglycemia in utero less than overt diabetes is associated with altered childhood glucose metabolism is unknown. We examined associations of gestational diabetes mellitus (GDM) not confounded by treatment with childhood glycemia in the Hyperglycemia and Adverse Pregnancy Outcome (HAPO) cohort. RESEARCH DESIGN AND METHODS HAPO Follow-up Study (FUS) included 4,160 children ages 10–14 years who completed all or part of an oral glucose tolerance test (OGTT) and whose mothers had a 75-g OGTT at ∼28 weeks of gestation with blinded glucose values. The primary predictor was GDM by World Health Organization criteria. Child outcomes were impaired fasting glucose (IFG), impaired glucose tolerance (IGT), and type 2 diabetes. Additional measures included insulin sensitivity and secretion and oral disposition index. RESULTS For mothers with GDM, 10.6% of children had IGT compared with 5.0% of children of mothers without GDM; IFG frequencies were 9.2% and 7.4%, respectively. Type 2 diabetes cases were too few for analysis. Odds ratios (95% CI) adjusted for family history of diabetes, maternal BMI, and child BMI z score were 1.09 (0.78–1.52) for IFG and 1.96 (1.41–2.73) for IGT. GDM was positively associated with child’s 30-min, 1-h, and 2-h but not fasting glucose and inversely associated with insulin sensitivity and oral disposition index (adjusted mean difference 276.3 [95% CI 2130.3 to 222.4] and 20.12 [20.17 to 20.064]), respectively, but not insulinogenic index. CONCLUSIONS Offspring exposed to untreated GDM in utero are insulin resistant with limited b-cell compensation compared with offspring of mothers without GDM. GDM is significantly and independently associated with childhood IGT.

Original languageEnglish (US)
Pages (from-to)372-380
Number of pages9
JournalDiabetes care
Volume42
Issue number3
DOIs
StatePublished - Mar 1 2019

Fingerprint

Gestational Diabetes
Pregnancy Outcome
Hyperglycemia
Mothers
Glucose
Glucose Intolerance
Fasting
Glucose Tolerance Test
Type 2 Diabetes Mellitus
Insulin Resistance
Research Design
Odds Ratio
Insulin
Pregnancy

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Advanced and Specialized Nursing

Cite this

on behalf of the HAPO Follow-up Study Cooperative Research Group*. / Hyperglycemia and adverse Pregnancy Outcome follow-up study (HAPO FUS) : Maternal gestational diabetes mellitus and childhood glucose metabolism. In: Diabetes care. 2019 ; Vol. 42, No. 3. pp. 372-380.
@article{329edc297fef46bcb94ee4353447f9cd,
title = "Hyperglycemia and adverse Pregnancy Outcome follow-up study (HAPO FUS): Maternal gestational diabetes mellitus and childhood glucose metabolism",
abstract = "OBJECTIVE Whether hyperglycemia in utero less than overt diabetes is associated with altered childhood glucose metabolism is unknown. We examined associations of gestational diabetes mellitus (GDM) not confounded by treatment with childhood glycemia in the Hyperglycemia and Adverse Pregnancy Outcome (HAPO) cohort. RESEARCH DESIGN AND METHODS HAPO Follow-up Study (FUS) included 4,160 children ages 10–14 years who completed all or part of an oral glucose tolerance test (OGTT) and whose mothers had a 75-g OGTT at ∼28 weeks of gestation with blinded glucose values. The primary predictor was GDM by World Health Organization criteria. Child outcomes were impaired fasting glucose (IFG), impaired glucose tolerance (IGT), and type 2 diabetes. Additional measures included insulin sensitivity and secretion and oral disposition index. RESULTS For mothers with GDM, 10.6{\%} of children had IGT compared with 5.0{\%} of children of mothers without GDM; IFG frequencies were 9.2{\%} and 7.4{\%}, respectively. Type 2 diabetes cases were too few for analysis. Odds ratios (95{\%} CI) adjusted for family history of diabetes, maternal BMI, and child BMI z score were 1.09 (0.78–1.52) for IFG and 1.96 (1.41–2.73) for IGT. GDM was positively associated with child’s 30-min, 1-h, and 2-h but not fasting glucose and inversely associated with insulin sensitivity and oral disposition index (adjusted mean difference 276.3 [95{\%} CI 2130.3 to 222.4] and 20.12 [20.17 to 20.064]), respectively, but not insulinogenic index. CONCLUSIONS Offspring exposed to untreated GDM in utero are insulin resistant with limited b-cell compensation compared with offspring of mothers without GDM. GDM is significantly and independently associated with childhood IGT.",
author = "{on behalf of the HAPO Follow-up Study Cooperative Research Group*} and Lowe, {William L.} and Scholtens, {Denise M.} and Alan Kuang and Barbara Linder and {Lowe Jr}, {William L} and Scholtens, {Denise M} and David McCance and Jill Hamilton and Michael Nodzenski and Octavious Talbot and Brickman, {Wendy J.} and Peter Clayton and Ma, {Ronald C.} and Tam, {Wing Hung} and Brickman, {Wendy Joy} and Catalano, {Patrick M.} and Lowe, {Lynn P.} and Metzger, {Boyd E}",
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Hyperglycemia and adverse Pregnancy Outcome follow-up study (HAPO FUS) : Maternal gestational diabetes mellitus and childhood glucose metabolism. / on behalf of the HAPO Follow-up Study Cooperative Research Group*.

In: Diabetes care, Vol. 42, No. 3, 01.03.2019, p. 372-380.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Hyperglycemia and adverse Pregnancy Outcome follow-up study (HAPO FUS)

T2 - Maternal gestational diabetes mellitus and childhood glucose metabolism

AU - on behalf of the HAPO Follow-up Study Cooperative Research Group

AU - Lowe, William L.

AU - Scholtens, Denise M.

AU - Kuang, Alan

AU - Linder, Barbara

AU - Lowe Jr, William L

AU - Scholtens, Denise M

AU - McCance, David

AU - Hamilton, Jill

AU - Nodzenski, Michael

AU - Talbot, Octavious

AU - Brickman, Wendy J.

AU - Clayton, Peter

AU - Ma, Ronald C.

AU - Tam, Wing Hung

AU - Brickman, Wendy Joy

AU - Catalano, Patrick M.

AU - Lowe, Lynn P.

AU - Metzger, Boyd E

PY - 2019/3/1

Y1 - 2019/3/1

N2 - OBJECTIVE Whether hyperglycemia in utero less than overt diabetes is associated with altered childhood glucose metabolism is unknown. We examined associations of gestational diabetes mellitus (GDM) not confounded by treatment with childhood glycemia in the Hyperglycemia and Adverse Pregnancy Outcome (HAPO) cohort. RESEARCH DESIGN AND METHODS HAPO Follow-up Study (FUS) included 4,160 children ages 10–14 years who completed all or part of an oral glucose tolerance test (OGTT) and whose mothers had a 75-g OGTT at ∼28 weeks of gestation with blinded glucose values. The primary predictor was GDM by World Health Organization criteria. Child outcomes were impaired fasting glucose (IFG), impaired glucose tolerance (IGT), and type 2 diabetes. Additional measures included insulin sensitivity and secretion and oral disposition index. RESULTS For mothers with GDM, 10.6% of children had IGT compared with 5.0% of children of mothers without GDM; IFG frequencies were 9.2% and 7.4%, respectively. Type 2 diabetes cases were too few for analysis. Odds ratios (95% CI) adjusted for family history of diabetes, maternal BMI, and child BMI z score were 1.09 (0.78–1.52) for IFG and 1.96 (1.41–2.73) for IGT. GDM was positively associated with child’s 30-min, 1-h, and 2-h but not fasting glucose and inversely associated with insulin sensitivity and oral disposition index (adjusted mean difference 276.3 [95% CI 2130.3 to 222.4] and 20.12 [20.17 to 20.064]), respectively, but not insulinogenic index. CONCLUSIONS Offspring exposed to untreated GDM in utero are insulin resistant with limited b-cell compensation compared with offspring of mothers without GDM. GDM is significantly and independently associated with childhood IGT.

AB - OBJECTIVE Whether hyperglycemia in utero less than overt diabetes is associated with altered childhood glucose metabolism is unknown. We examined associations of gestational diabetes mellitus (GDM) not confounded by treatment with childhood glycemia in the Hyperglycemia and Adverse Pregnancy Outcome (HAPO) cohort. RESEARCH DESIGN AND METHODS HAPO Follow-up Study (FUS) included 4,160 children ages 10–14 years who completed all or part of an oral glucose tolerance test (OGTT) and whose mothers had a 75-g OGTT at ∼28 weeks of gestation with blinded glucose values. The primary predictor was GDM by World Health Organization criteria. Child outcomes were impaired fasting glucose (IFG), impaired glucose tolerance (IGT), and type 2 diabetes. Additional measures included insulin sensitivity and secretion and oral disposition index. RESULTS For mothers with GDM, 10.6% of children had IGT compared with 5.0% of children of mothers without GDM; IFG frequencies were 9.2% and 7.4%, respectively. Type 2 diabetes cases were too few for analysis. Odds ratios (95% CI) adjusted for family history of diabetes, maternal BMI, and child BMI z score were 1.09 (0.78–1.52) for IFG and 1.96 (1.41–2.73) for IGT. GDM was positively associated with child’s 30-min, 1-h, and 2-h but not fasting glucose and inversely associated with insulin sensitivity and oral disposition index (adjusted mean difference 276.3 [95% CI 2130.3 to 222.4] and 20.12 [20.17 to 20.064]), respectively, but not insulinogenic index. CONCLUSIONS Offspring exposed to untreated GDM in utero are insulin resistant with limited b-cell compensation compared with offspring of mothers without GDM. GDM is significantly and independently associated with childhood IGT.

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U2 - 10.2337/dc18-1646

DO - 10.2337/dc18-1646

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JF - Diabetes Care

SN - 1935-5548

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