In Utero Diabetes Exposure May Predispose to Type 2 Diabetes at Earlier Age

Exposure to a diabetic intrauterine environment is associated with an earlier age at diagnosis of type 2 diabetes in offspring, according to findings from the SEARCH for Diabetes in Youth Study - a survey of ethnically diverse people diagnosed with diabetes before age 20 years.

"This study helps explain why other studies have found higher age-specific rates of type 2 diabetes among offspring of women with diabetes," note Dr. David J. Pettitt from the Sansum Diabetes Research Institute, Santa Barbara, California, and colleagues in the November issue of Diabetes Care.

The study sample included 2,342 young patients with type 1 diabetes and 331 with type 2 diabetes. A total of 269 subjects with type 1 diabetes and 174 with type 2 diabetes had a family history of diabetes.

Dr. Pettitt and colleagues observed that individuals with type 2 diabetes were significantly more likely than subjects with type 1 diabetes to have a parent with diabetes (type 1 or type 2).

They also discovered that type 2 diabetes was diagnosed 1.68 years earlier among the 174 young patients exposed to diabetes in utero than among those whose mothers' diabetes was not diagnosed until after the offspring's birth.

"The significance of this finding persisted when analyses were controlled for the age at which the mothers' diabetes was diagnosed," the investigators note.

Among youth with type 1 diabetes, the effect of intrauterine exposure was not significant when controlled for the mother's age at diagnosis. Father's diabetes before birth was not associated with age at diagnosis of type 1 or type 2 diabetes.

These findings, note Dr. Pettitt and colleagues, "suggest that the hyperglycemic intrauterine environment predisposes to an earlier onset of type 2 diabetes, whereas the age of onset of type 1 diabetes is largely familial, is possibly genetic, and is influenced very little by the intrauterine milieu."

As rates of obesity and type 2 diabetes increase, more young women will be exposing their unborn children to hyperglycemia. "Thus, children exposed at this early stage of life to abnormal nutrients from their diabetic mothers need to be followed carefully, and known risk factors, such as obesity, hypertension, and hyperlipidemia, need early treatment," the investigators conclude.


Diabetes Care 2008;31:2126-2130.

From Reuters Health Information
In Utero Diabetes Exposure May Predispose to Type 2 Diabetes at Earlier Age
NEW YORK (Reuters Health) Nov 27