Type 2 diabetes linked to prenatal diabetic environment?

May 29, 2003

A preliminary study in this week's issue of THE LANCET suggests that offspring of mothers with type 1 diabetes could be at an increased risk of type 2 diabetes in adult life--even in the absence of inherited type 1 or type 2 diabetic disease.

Type 2 diabetes generally occurs in adulthood and is caused by both genetic and environmental factors (such as obesity). Jean-Francois Gautier from Hôpital Saint-Louis, Paris, France, and colleagues assessed whether prenatal exposure to a diabetic environment is associated with metabolic disorders in later adult life, which can lead to type 2 diabetes. The investigators assessed glucose tolerance and metabolic abnormalities that are predisposing to type 2 diabetes in offspring of mothers or fathers with type 1 diabetes. The confounding effect of genetic predisposition for type 2 diabetes was avoided by ensuring there was no family history of type 2 diabetes in either parent.

Insulin production in response to oral and intravenous glucose was measured in 15 non-diabetic adult offspring of mothers with type 1 diabetes (exposed participants) and 16 offspring of type 1 diabetic fathers (the control group). None of the participants had inherited type 1 diabetes.

A third of the participants prenatally exposed to a diabetic environment from mothers with type 1 diabetes had glucose intolerance compared with none of the control group; insulin secretion was both lower in concentration and slower in release than among participants in the control group.

Jean-Francois Gautier comments: "Exposure to a diabetic environment in utero is associated with increased occurrence of impaired glucose tolerance and a defective insulin secretory response in adult offspring, independent of genetic predisposition to type 2 diabetes. Epidemiological studies are needed to confirm our observations before therapeutic strategies can be devised."
Contact : Professor Jean-Francois Gautier, Service de Diabetologie, Hôpital Saint-Louis, 1, avenue Claude Vellefaux, 75010 Paris, France;
T) 33-142-494-857;
F) 33-142-494-178;
E) j-fgautier@wanadoo.fr


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