Endocrine Abstracts

Epidemiologic studies support a relationship of lower birth weight with later disease- particularly type 2 diabetes. These findings may reflect either the influence of environmental factors before birth to influence risk of later disease (in utero programming) or pleiotropic genetic effects. In high risk populations, notably the Pima Indians of Southern Arizona, both low and high birth weight are associated with later risk of type 2 diabetes. In addition, long term follow up studies support the hypothesis that maternal diabetes results in programming of type 2 diabetes and obesity in utero. The mechanisms of in utero programming by maternal diabetes remain largely unknown. Recent studies in offspring of mothers with type 1 diabetes allow detailed examination of the hormonal effects of maternal diabetes on the offspring. Future follow up studies will highlight how such hormonal changes- such as the marked hyperleptinaemia and hyperinsulinaemia that are found in offspring of mothers with diabetes- might lead to later disease.