Maternal GDM in Hispanic Youth: Risk for Obesity
Maternal GDM in Hispanic Youth: Risk for Obesity
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.
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.
Inclusion Criteria:

 -  Offspring between the ages of 4 and 18 years old who were born to women who
 participated in the BetaGene Study.

 Exclusion Criteria:

 -  Offspring < 4 or > 18 years of age;

 -  gestation < 36 weeks at birth;

 -  significant medical illness and/or current use of medication known to influence
 glucose tolerance or BMI.