Wicklow - diabetic pregnancy outcomes

A lot of the information that we have gleaned in terms of fetal outcomes of moms who are diagnosed with diabetes in pregnancy come from large cohort studies, so following pregnant moms and their offspring for a period of time to look to see whether or not they develop obesity, whether or not they develop insulin resistance and type 2 diabetes, whether or not they develop systolic hypertension.  So this clustering of things which is often called the metabolic syndrome or cardiometabolic risk factors in offspring.  We know that compared to moms who don’t have diabetes in utero, kids are at higher risk of obesity, higher risk of metabolic syndrome and higher risk of type 2 diabetes developed either in childhood or in adulthood.  There’s a difference between the type of diabetes they appear to be exposed to in utero and the risk in terms of cardiometabolic risk as offspring.  So we know that type 1 diabetes, gestational diabetes and pregestational or type 2 diabetes diagnosed in a pregnant woman are all risk factors for offsprings having higher systolic blood pressure, higher risk of type 2 diabetes, higher risk of insulin resistance.  But it appears that when we tease those out that the risk if you have gestational diabetes is about four times higher than the risk if you have type 1 and the risk of pregestational type 2 diabetes is about 14 times higher in offspring to have some form of increased cardiometabolic risk and risk of type 2 diabetes themselves when they reach adulthood.