424 Long-Term Effect of Pregestational and Gestational Diabetes Mellitus on Offspring

Abstract

Background: It has been suggested that maternal diabetes during pregnancy increases childhood risk of developing obesity and impaired glucose tolerance. The aim of the study was to compare the impact of pregestational (PGDM) and gestational (GDM) diabetes on selected metabolic and developmental parameters in children of diabetic mothers. Material and methods: A total of 26 offspring of mothers with PGDM and 28 offspring of mothers with GDM were examined at 4–8 years of age. All children had an oral glucose tolerance test (OGTT) performed, with glucose and insulin measured at 0, 30, 60 and 120 min after loading. Glycated hemoglobin and lipids levels were measured in fasting plasma. Basic body measurements were taken and BMI and symmetry index were calculated. Results: Offspring of mothers with GDM had higher BMI (17.1 ± 2.28 vs. 15.8 ± 2.52; p<0.05), symmetry index (1.12 ± 0.18 vs. 1.02 ± 0.18; p<0.01) and percentage of age-adjusted normal body weight (114.72 ± 21.93 vs. 101.32 ± 19.58; p<0.05) than offspring of mothers with PGDM. Similarly, the percentage of children with body weight, BMI and symmetry index above 75th percentile was also significantly higher in offspring of mothers with GDM compared to offspring of mothers with PGDM (respectively: 31.5% vs. 11.1%, 29.6% vs. 11.1% and 29.6% vs. 11.1%; p<0.05). Fasting glucose, cholesterol, triglyceride, LDL and glycated hemoglobin levels as well as glucose tolerance were not significantly different between groups. Conclusions: GDM seems to predispose to higher body weight, BMI and symmetry index in offspring compared to PGDM. However, there is no difference in glucose tolerance, glycated hemoglobin and lipids levels between both groups. The tendency to overweight and obesity observed in offspring of mothers with GDM is type 2 diabetes risk factor and might be related to the fetal metabolic experience, genetic predisposition or family life style.