Developmental programming and diabetes - The human experience and insight from animal models

Area of Science:

• Reproductive health
• Pediatric endocrinology
• Metabolic disorders

Background:

• Maternal diabetes, including type 1 DM and type 2 DM, may increase offspring's risk for later-life diabetes and obesity.
• This suggests potential in utero or early postnatal influences on child development.

Purpose of the Study:

• To review existing studies on the hypothesis that maternal diabetes influences offspring's long-term metabolic health.
• To highlight controversies such as confounding factors and maternal BMI influence.

Main Methods:

• Review of existing literature on maternal diabetes and offspring health outcomes.
• Examination of animal models demonstrating effects of maternal hyperglycemia.
• Consideration of prospective study designs.

Main Results:

• Animal studies show maternal hyperglycemia can cause lasting issues in offspring, including pancreatic beta-cell dysfunction, altered insulin signaling, and hypothalamic abnormalities affecting energy regulation and obesity.
• Human studies suggest a correlation between maternal diabetes and offspring susceptibility to metabolic diseases.

Conclusions:

• Maternal diabetes may have transgenerational effects on offspring's susceptibility to diabetes and obesity.
• Further prospective studies, especially those following children from randomized controlled trials (RCTs) of glycemic control in diabetic mothers, are needed to confirm these findings and elucidate mechanisms.