Clinical Characteristics of Offspring Born to Parents with Type 2 Diabetes Diagnosed in Youth: Observations from TODAY

TL;DR

Children born to parents with youth-onset type 2 diabetes face health and educational challenges, possibly due to in utero diabetes exposure and socioeconomic factors.

Contribution

This study explores health and educational outcomes in offspring of parents with youth-onset type 2 diabetes, focusing on in utero exposure and socioeconomic disparities.

Findings

Offspring of TODAY mothers had higher rates of medication use and educational plans compared to offspring of TODAY fathers.

Socioeconomic disadvantages were more common among offspring of TODAY mothers, including lower household income and higher recidivism rates.

Overweight rates in offspring were reported at 16.7%, with no sex difference observed.

Abstract

Diabetes exposure during pregnancy affects health outcomes in offspring; however, little is known about in utero exposure to preexisting parental youth-onset type 2 diabetes. Offspring born to participants during the Treatment Options for Type 2 Diabetes in Adolescent and Youth (TODAY) study were administered a questionnaire at the end of the study. Of 457 participants, 37% of women and 18% of men reported 228 offspring, 80% from female participants. TODAY mothers had lower household income (<$25,000) compared to TODAY fathers (69.4% vs. 37.9%, p = 0.0002). At 4.5 years of age (range 0–18 years), 16.7% of offspring were overweight according to the parental report of their primary care provider, with no sex difference. Offspring of TODAY mothers reported more daily medication use compared to TODAY fathers (50/183, 27.7% vs. 6/46, 12.2%, [p = 0.04]), a marker of overall health. TODAY mothers also reported higher rates of recidivism (13/94) than TODAY fathers (0/23). An Individualized Education Plan was reported in 20/94 (21.3%) offspring of TODAY mothers compared to 2/23 (8.7%) of TODAY fathers. This descriptive study, limited by parental self-reports, indicated offspring of participants in TODAY experience significant socioeconomic disadvantages, which, when combined with in utero diabetes exposure, may increase their risk of health and educational disparities.