Metabolic experiences in utero, as reflected by a high amniotic fluid insulin concentration, may condition diabetes-associated risk factors such as high BMI (1).
As part of our survey (performed between June and September 2000) of overweight and obese Uruguayan children (age 9–12 years) and the contributing factors of their condition, we evaluated the incidence of maternal transmission of diabetes.
The cross-sectional survey comprised 886 children (452 boys and 434 girls), living in Montevideo, Uruguay, and other cities in Uruguay with >10,000 inhabitants, who were interviewed at home in the presence of at least one parent. The sample was stratified, aleatory, polyetapic, and systematic according to the last national survey (2) and represented an urban population (total 3,200,000: 91% living in urban zone, 88% Caucasian, 8% crossbred, and 4% black). The children were weighed and measured in light clothes and without shoes using equal balances and scales. BMI was calculated according to tables (3) for age and sex. Three subgroups were established: normal weight (NW) (BMI ≤ 85th percentile), overweight (OW) (BMI 85th to 94.9th percentiles), and obese (OB) (BMI ≥ 95th percentile). Incidence of antecedent diabetes was inquired and recorded for both the mother and father.
A total of 17% of the children were classified as OW and 9% as OB. No differences in BMI were found between sexes at the age interval studied. All of the mothers in the OB group had type 2 diabetes, 1% of the mothers in the NW and OW groups had type 1 diabetes, and no differences were found between diabetic and nondiabetic fathers. This maternal transmission of type 2 diabetes was addressed in a recent study (4).
These are the first data regarding Uruguayan children that emphasize the significance of intrauterine environment with respect to exceeding transmission obesity and insulin resistance (a prediabetic condition). Recent reports have suggested that early consequences of an adverse in utero environment do not seem to be attenuating with time (5). Considering the vertiginous increase in type 2 diabetes among adolescents (6) and the pivotal role that obesity plays in the disease (7), we feel these data are very important for the prevention of type 2 diabetes in our clinical practice.
Address correspondence to Dr. Raúl Pisabarro, Universidad de la Republica Domingo Cullen 693, Montevideo, CP 11300, Uruguay. E-mail: email@example.com.