Gestational Diabetes Mellitus and Long-Term Prognosis of the Offsprings / 임상당뇨병

ABSTRACT

The hyperglycemia and adverse pregnancy outcomes (HAPO) study demonstrated a linear increase in the risk of adverse pregnancy outcomes with increasing maternal glycemia that can be less severe than overt diabetes and is often untreated. Recently, HAPO follow-up studies were published on longterm consequences on children of gestational diabetes mellitus (GDM) gravidas. Two articles examined the association of untreated maternal glycemia with markers of glucose metabolism in a total of 4,160 ethnically diverse children 10~14 years of age. Children of mothers with GDM had higher prevalence of impaired glucose tolerance (IGT). Moreover, there were strong positive associations between maternal continuous and categorical glycemia status and child’s 75-g glucose tolerance test, A1C, IGT, and impaired fasting glucose. Another two articles evaluated the risk of childhood adiposity of 4,832 children born from mothers with GDM. GDM was associated with childhood adiposity as evaluated by multiple methods. Additionally, maternal glucose level across a continuum was associated with childhood obesity, percentage body fat, and sum of skinfolds > 85th percentile after adjustment for maternal body mass index. These findings could have implications for glucose targets in mothers with GDM and indicate that even mild hyperglycemia can affect adversely glucose metabolism and obesity in the children of mothers with GDM.