Mothers who develop gestational diabetes have a higher risk of developing type 2 diabetes in later life, and their children are known to develop greater adiposity and have an increased risk of young-onset obesity and type 2 diabetes. Gestational diabetes is an example of an exposure that programmes the fetus through an oversupply of nutrients (glucose, lipids and amino acids).
The Mysore Parthenon Study (link to Mysore Parthenon Cohort) was set up to study the long-term effects of gestational diabetes mellitus (GDM) on children. It has shown that babies born to GDM mothers were larger at birth and had more subcutaneous fat than children of non-GDM mothers. The difference in adiposity continued throughout childhood (Figure (a)), and at 9 and 13 years the children of GDM mothers had higher glucose and insulin concentrations (Figure (b)) and higher insulin resistance.
We have also measured children’s ‘stress responses’: cortisol levels (reflecting HPA axis activation) and cardiovascular responses (reflecting sympathetic nervous system activation) during a Trier Social Stress Test (TSST). In the TSST, participants are asked to perform a public speaking task and mental arithmetic task in front of a panel of unfamiliar ‘judges’; it takes about 20 minutes. It is a method used in research to create a feeling of stress. The study showed that children of GDM mothers had normal cortisol responses during the TSST, but had greater cardiovascular responses (higher pulse rate, blood pressure, stroke volume and cardiac output) than children of non-GDM mothers (Figure (c).