Overweight and the Metabolic Syndrome in Adult Offspring of Women with Diet-Treated Gestational Diabetes Mellitus or Type 1 Diabetes
Abstract
CONTEXT: In animal studies, exposure to intrauterine hyperglycemia increases the risk of cardiovascular disease through only partly understood epigenetic mechanisms. Human long-term follow-up studies on the same topic are few. OBJECTIVE: The aim was to study the risk of overweight and the metabolic syndrome in adult offspring of women with diet-treated gestational diabetes mellitus (GDM) or type 1 diabetes, and additionally to study associations between estimates of maternal hyperglycemia and outcome in the offspring. DESIGN AND SETTING: We conducted a follow-up study of 1066 primarily Caucasian women aged 18-27 yr in the Center for Pregnant Women with Diabetes, Rigshospitalet, Copenhagen, Denmark. PARTICIPANTS: Offspring of women with diet-treated GDM (n = 168) and an unexposed reference group (n = 141) participated, as well as offspring of women with type 1 diabetes (n = 160) and offspring from the background population representing an unexposed reference group (n = 128). The follow-up rate was 56% (597 of 1066). MAIN OUTCOME MEASURES: Women with body mass index of at least 25 kg/m(2) were considered overweight. The metabolic syndrome was determined by the International Diabetes Federation 2006 criteria. RESULTS: The risk of overweight was doubled in offspring of women with diet-treated GDM or type 1 diabetes compared with offspring from the background population, whereas the risk of the metabolic syndrome was 4- and 2.5-fold increased, respectively. Offspring risk of the metabolic syndrome increased significantly with increasing maternal fasting blood glucose as well as 2-h blood glucose (during oral glucose tolerance test). CONCLUSIONS: Adult offspring of women with diet-treated GDM or type 1 diabetes are risk groups for overweight and the metabolic syndrome. Intrauterine hyperglycemia may in addition to genetics and other factors contribute to the pathogenesis of overweight and the metabolic syndrome.
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The incidence ratio of offspring exposed to every type of maternal diabetes was increased by 29% compared to non-exposed offspring, with increased risk observed in every age group.
“The incidence ratio of offspring exposed to every type of maternal diabetes was increased by 29% compared to non-exposed offspring, and the increase in risk was observed in every age group (<20 years old; >20 years old) [33,62,63,64,65].”
From Maternal Overnutrition and Fetal Programming: Long-Term Metabolic, Cognitive, and Epigenetic Consequences (2026) · cites this paper as [63]
Recent epidemiological studies show a relationship between increased risk of cardiometabolic diseases in adulthood for offspring of women whose pregnancy was complicated by GDM.
“Recent epidemiological studies show a relationship between an increased risk of cardiometabolic diseases in adulthood for offspring of women whose pregnancy has been complicated by GDM.”
From Maternal Overnutrition and Fetal Programming: Long-Term Metabolic, Cognitive, and Epigenetic Consequences (2026) · cites this paper as [63]
Yu Y. et al. demonstrated an association between gestational diabetes and an increased rate of early-onset cardiovascular diseases (≤40 years old) in offspring.
“A large study conducted by Yu Y. et al. demonstrated an association between gestational diabetes and an increased rate of early-onset cardiovascular diseases (CVD; ≤40 years old) in offspring.”
From Maternal Overnutrition and Fetal Programming: Long-Term Metabolic, Cognitive, and Epigenetic Consequences (2026) · cites this paper as [63]
A limited number of studies linked gestational diabetes mellitus exposure to increased cardiovascular disease risk in the offspring.
“A limited number of studies linked GDM exposure to increased CVD risk in the offspring [73,83,84,85,86].”
From Recent Experimental Studies of Maternal Obesity, Diabetes during Pregnancy and the Developmental Origins of Cardiovascular Disease (2022) · cites this paper as [83]
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- Authors
- Clausen, T. D., Mathiesen, E. R., Hansen, T., Pedersen, O., Jensen, D. M., Lauenborg, J., Schmidt, L., & Damm, P.
- Affiliations
- University of Copenhagen (DK)
- Steno Diabetes Center (T.H., O.P.), 2820 Gentofte, Denmark
- Odense University Hospital (DK)
- Corresponding author
- Clausen, Tine D.
- ORCID
- Venue
- The Journal of Clinical Endocrinology & Metabolism
- Publisher
- The Endocrine Society
- Published
- 2009-07-01
- Volume
- 94
- Issue
- 7
- Pages
- 2464-2470
- ISSN
- 0021-972X (ISSN-L)
- 1945-7197
- OpenAlex
- W2045372180
- Cited by
- 453
- References
- 4
- Citations by year
- 2026: 7 · 2025: 16 · 2024: 21 · 2023: 24 · 2022: 34 · 2021: 35 · 2020: 32 · 2019: 25 · 2018: 52 · 2017: 37 · 2016: 23 · 2015: 31 · 2014: 24 · 2013: 29 · 2012: 21
- FWCI
- 24.04
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
- PubMed (publishedVersion)
- University of Southern Denmark Research Portal (University of Southern Denmark) (publishedVersion)
- Research at the University of Copenhagen (University of Copenhagen) (submittedVersion)
- Topics
- Health Sciences › Medicine › Obstetrics and Gynecology › Gestational Diabetes Research and Management
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Birth, Development, and Health
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Keywords
- gestational diabetes mellitus, type 1 diabetes, intrauterine hyperglycemia, adult offspring, overweight, metabolic syndrome, maternal hyperglycemia, fasting blood glucose, oral glucose tolerance test, epigenetic mechanisms, cardiovascular risk
- MeSH terms
- Adolescent, Adult, Algorithms, Diabetes Mellitus, Type 1, Female, Follow-Up Studies, Humans, Male, Pregnancy, Pregnancy in Diabetics, Prenatal Exposure Delayed Effects, Risk Factors, Cohort Studies, Child of Impaired Parents, Diabetes, Gestational, Metabolic Syndrome, Adult Children, Overweight, Young Adult
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