December 10, 2025
2 min read
Key takeaways:
- High maternal glucose and high type 2 diabetes genetic risk both increased IGT odds for children.
- Type 2 diabetes incidence was highest among those with gestational diabetes exposure plus high genetic risk.
Children with a high genetic risk for type 2 diabetes who were also exposed to maternal gestational diabetes are more likely to develop impaired glucose tolerance and type 2 diabetes, according to a speaker.
Data published in Morbidity and Mortality Weekly Report in 2020 showed that the incidence of type 2 diabetes among children in the U.S. increased from 2002 to 2015. Abigayil C. Dieguez, MD, assistant professor of pediatric endocrinology at the Ann and Robert H. Lurie Children’s Hospital of Chicago and Northwestern University Feinberg School of Medicine, said several previously published studies have found type 2 diabetes progresses more rapidly in children than adults.
Data derived from Dieguez AC. Session 10 – Joint session with Diabetes Care. Presented at: World Congress on Insulin Resistance, Diabetes and Cardiovascular Disease; Dec. 3-6, 2025; Los Angeles.
“Type 2 diabetes in youth is a very complex, multifactorial disease,” Dieguez said during a presentation at the World Congress on Insulin Resistance, Diabetes and Cardiovascular Disease. “It’s important to acknowledge the modifiable and nonmodifiable factors that contribute to its progression, pathogenesis and disparities in health.”
Dieguez said two of the factors contributing to type 2 diabetes in children are genetic risk and intrauterine exposures, and she discussed a study published in Diabetes Care that examined the impact of both of those factors on type 2 diabetes incidence.
Researchers used data from the Hyperglycemia and Adverse Pregnancy Outcome (HAPO) Follow-up Study conducted from 2013 to 2016. Genetic risk was assessed using DNA collected from 3,444 children. A type 2 diabetes genetic risk score was created using data from a multiancestry genome-wide association study. Children in the 75th percentile or higher for genetic risk score were defined as being at high risk for type 2 diabetes, whereas those below the 75th percentile were considered to have low risk. The sum of glucose z scores collected during fasting, 1-hour and 2-hour oral glucose tolerance tests were used to assess maternal hyperglycemia. Children had IGT with a 2-hour glucose level of 140 mg/dL to 199 mg/dL, whereas type 2 diabetes was defined as a fasting glucose of 126 mg/dL or higher, a 2-hour glucose of 200 mg/dL or greater, or a self-reported diagnosis.In a fully adjusted model, higher maternal glycemia z score (OR = 1.12; 95% CI, 1.05-1.19) and higher type 2 diabetes genetic risk score (OR = 1.35; 95% CI, 1.13-1.63) were associated with increased odds for IGT and type 2 diabetes.
The prevalence of IGT and type 2 diabetes was 15.92% for children with high genetic risk for type 2 diabetes and a mother with gestational diabetes vs. 8.36% for those with low genetic risk and a mother with gestational diabetes, 6.17% for children with high genetic risk and a mother without gestational diabetes and 5.64% for children with low genetic risk and no maternal gestational diabetes exposure.
Dieguez said several factors could contribute to the link between maternal hyperglycemia and IGT risk for offspring with a high genetic risk for type 2 diabetes, including shared prenatal or postnatal environments between the child and mother, as well as epigenetic changes.
“Early-life risk stratification could inform targeted intervention in high-risk children particularly,” Dieguez said.
Dieguez said one of the limitations of the study was that the genetic risk score was based on an adult study, and future studies should develop a genetic risk score based on a pediatric genome-wide association study. Future studies should validate the findings in other cohorts and examine epigenetic mediators of hyperglycemia contributing to IGT and type 2 diabetes risk for children, Dieguez said.
Sources/Disclosures
Source:
Dieguez AC. Session 10 – Joint session with Diabetes Care. Presented at: World Congress on Insulin Resistance, Diabetes and Cardiovascular Disease; Dec. 3-6, 2025; Los Angeles.
References:
Disclosures:
Dieguez reports no relevant financial disclosures.
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