Increased metabolic risk in adolescent offspring of mothers with type 1 diabetes: the EPICOM study

TY - JOUR

T1 - Increased metabolic risk in adolescent offspring of mothers with type 1 diabetes

T2 - the EPICOM study

AU - Vlachová, Zuzana

AU - Bytoft, Birgitte

AU - Knorr, Sine

AU - Clausen, Tine D

AU - Jensen, Rikke Beck

AU - Mathiesen, Elisabeth R

AU - Højlund, Kurt

AU - Ovesen, Per

AU - Beck-Nielsen, Henning

AU - Gravholt, Claus H

AU - Damm, Peter

AU - Jensen, Dorte M

PY - 2015/7/20

Y1 - 2015/7/20

N2 - Aims/hypothesis: We aimed to investigate metabolic risk factors, insulin sensitivity and insulin secretion in adolescent offspring of mothers with type 1 diabetes compared with offspring of non-diabetic mothers. Methods: During 1993–1999, pregnancies of women with type 1 diabetes in Denmark were prospectively reported to a central registry in the Danish Diabetes Association. Data included information on maternal demography, diabetes status and pregnancy outcome. We invited 746 eligible children from this cohort (index offspring) to a follow-up examination. Control offspring were identified through The Danish Central Office of Civil Registration and matched with respect to date of birth, sex and postal code. Anthropometric measurements and blood sampling for metabolic characterisation, including an oral glucose tolerance test, were performed. Results: We examined 278 index offspring (mean age 16.7 years; range 13.0–19.8 years) and 303 control offspring (mean age 16.8 years; range 13.5–20.4 years). Index offspring had higher BMI SD score (0.44: 95% CI 0.21, 0.66) compared with controls, after adjustments for pubertal development and maternal pre-pregnancy BMI. Furthermore, index offspring had a higher prevalence of components included in metabolic syndrome and prediabetes (impaired fasting glucose and/or impaired glucose tolerance), with reduced insulin sensitivity and relative insulin secretion deficiency, compared with controls. Maternal HbA1c levels in pregnancy were not directly associated with offspring metabolic outcomes. Conclusions/interpretation: Adolescent offspring of mothers with type 1 diabetes had a less favourable metabolic profile and higher frequency of prediabetes than the background population. Significant associations between these outcomes and maternal HbA1c levels in pregnancy could not be demonstrated. Trial registration: ClinicalTrials.gov

AB - Aims/hypothesis: We aimed to investigate metabolic risk factors, insulin sensitivity and insulin secretion in adolescent offspring of mothers with type 1 diabetes compared with offspring of non-diabetic mothers. Methods: During 1993–1999, pregnancies of women with type 1 diabetes in Denmark were prospectively reported to a central registry in the Danish Diabetes Association. Data included information on maternal demography, diabetes status and pregnancy outcome. We invited 746 eligible children from this cohort (index offspring) to a follow-up examination. Control offspring were identified through The Danish Central Office of Civil Registration and matched with respect to date of birth, sex and postal code. Anthropometric measurements and blood sampling for metabolic characterisation, including an oral glucose tolerance test, were performed. Results: We examined 278 index offspring (mean age 16.7 years; range 13.0–19.8 years) and 303 control offspring (mean age 16.8 years; range 13.5–20.4 years). Index offspring had higher BMI SD score (0.44: 95% CI 0.21, 0.66) compared with controls, after adjustments for pubertal development and maternal pre-pregnancy BMI. Furthermore, index offspring had a higher prevalence of components included in metabolic syndrome and prediabetes (impaired fasting glucose and/or impaired glucose tolerance), with reduced insulin sensitivity and relative insulin secretion deficiency, compared with controls. Maternal HbA1c levels in pregnancy were not directly associated with offspring metabolic outcomes. Conclusions/interpretation: Adolescent offspring of mothers with type 1 diabetes had a less favourable metabolic profile and higher frequency of prediabetes than the background population. Significant associations between these outcomes and maternal HbA1c levels in pregnancy could not be demonstrated. Trial registration: ClinicalTrials.gov

KW - Adolescent

KW - Adult

KW - Anthropometry

KW - Denmark

KW - Diabetes Mellitus, Type 1

KW - European Continental Ancestry Group

KW - Female

KW - Glucose Tolerance Test

KW - Hemoglobin A, Glycosylated

KW - Humans

KW - Insulin

KW - Insulin Resistance

KW - Male

KW - Metabolic Diseases

KW - Mothers

KW - Pregnancy

KW - Pregnancy Outcome

KW - Pregnancy in Diabetics

KW - Risk Factors

KW - Young Adult

U2 - 10.1007/s00125-015-3589-5

DO - 10.1007/s00125-015-3589-5

M3 - Journal article

C2 - 25924986

SN - 0012-186X

VL - 58

SP - 1454

EP - 1463

JO - Diabetologia

JF - Diabetologia

IS - 7

ER -