Maternal GDM in Hispanic Youth: Risk for Obesity
Condition: Diabetes, Gestational; Obesity; Insulin Resistance; Insulin Secretion
MeSH terms: Diabetes, Gestational; Obesity; Insulin Resistance
Study type: Observational

Summary: 
      Our studies are aimed at examining effects of intrauterine exposure to GDM on metabolic risks
      in Hispanic children. Our primary hypothesis predicts that intrauterine exposure to GDM will
      be associated with one or more of three critical factors involved in the development of
      diabetes: 1) increased adiposity, 2) insulin resistance, and 3) decreased beta cell function
      in Hispanic children when compared to non-exposed children matched for ethnicity, age,
      gender, and Tanner stage. In a subset of this cohort, we will also examine the effects of
      intrauterine exposure to gestational diabetes on the brain pathways that regulate appetite
      and body weight in children ages 6 to 15 years old.
    

Detailed description: 
      Obesity rates have increased dramatically over the last two decades, particularly in
      children. Obesity is a major risk factor for type 2 diabetes (T2D), and there is a
      disproportionate prevalence of obesity and T2D in people of Hispanic origin. While a number
      of factors contribute to the development of obesity and T2D there is compelling evidence
      suggesting a profound role of the diabetic in utero environment. Epidemiological studies show
      that exposure to maternal diabetes in utero is associated with a significant risk of
      developing obesity and diabetes later in life. Provocative studies in animal models suggest
      that metabolic imprinting resulting from exposure to the altered metabolic milieu of diabetes
      in pregnancy leads to abnormalities in the development of specific fetal tissues, including
      the hypothalamus and pancreatic islets. Based on these findings, the goal of this research is
      to test the hypothesis that exposure to maternal gestational diabetes mellitus in utero
      results in changes during intrauterine development that mediate increased risk for obesity
      and diabetes. Through our ongoing studies on the genetics of type 2 diabetes we have access
      to hundreds of Hispanic offspring of well characterized GDM and control mothers. We are,
      therefore, in the unique position to perform mechanistic studies examining effects of
      intrauterine exposure to GDM on metabolic risks in Hispanic children and adolescents. Our
      primary hypothesis predicts that intrauterine exposure to GDM will be associated with one or
      more of three critical factors involved in the development of diabetes: 1) increased
      adiposity, 2) insulin resistance, and 3) decreased beta cell function in Hispanic children
      when compared to non-exposed children matched for ethnicity, age, gender, and Tanner stage.

      To examine the effects of exposure to GDM on brain pathways involved in the regulation of
      energy homeostasis, we will perform additional functional magnetic resonance imaging (fMRI)
      studies in a subset of the larger cohort.
    

Observational model: Case-Control
Time perspective: Retrospective
Sampling method: Non-Probability Sample
Study population: 
        GDM exposed and non-exposed Hispanic offspring of singleton pregnancies between the ages of
        4 to 18 years old. Offspring are the children of women with a history of GDM or with normal
        glucose levels during pregnancy who participated in the BetaGene Study. Normal glucose
        levels during pregnancy are defined as 1-hour 50g glucose challenge test <120 mg/dl. GDM
        diagnosis is defined as two or more abnormal values on 3-h 100-g diagnostic OGTT. GDM
        defined by American Diabetes Association Criteria in place from 2003-2008.
      
Keywords: Gestational Diabetes Mellitus; Childhood Obesity; Offspring