Faculty Opinions recommendation of Metformin in gestational diabetes: the offspring follow-up (MiG TOFU): body composition and metabolic outcomes at 7-9 years of age.

Background and Objectives: There is lack of knowledge on whether mothers’ gestational diabetes (GDM) risk is related to their physical activity (PA) or their children’s PA and body composition. We aimed to examine the difference in (1) change in self-reported PA from pre-pregnancy to seven-year follow-up and (2) accelerometer-based PA at seven years after delivery between the mothers having GDM risk (GDMRyes-mothers) and not having GDM risk (GDMRno-mothers). Furthermore, we examined the difference in children’s PA and/or body composition at six years of age according to their mothers’ GDM risk. Materials and Methods: The study included 199 Finnish women. GDM risk factors were screened at the beginning of pregnancy, and the women were classified as GDMRyes-mothers if they had at least one GDM risk factor (body mass index ≥25 kg/m2; age ≥40 years; family history of diabetes; GDM, signs of glucose intolerance, or newborn’s macrosomia (≥4500 g) in earlier pregnancy) or as GDMRno-mothers if they had no risk factors. Mothers’ PA was assessed by self-reporting at 8–12 gestational weeks concerning pre-pregnancy PA and at a follow-up seven years after the delivery. Moreover, mothers’ and their children’s PA was measured using a triaxial Hookie AM20-accelerometer at seven years after delivery. Children’s body composition was assessed using a TANITA bioelectrical impedance device. Adjusted linear regression analyses were applied. Results: GDMRno-mothers increased their self-reported PA more than GDMRyes-mothers from pre-pregnancy to the seven-year follow-up. Concerning women’s measured PA as well as children’s PA and body composition at seven years after delivery, the differences were non-significant between GDMRyes-mothers and GDMRno-mothers. However, of the GDM risk factors, mothers’ pre-pregnancy body mass index was positively related to unhealthier body composition in boys at six years of age. Conclusion: Health promotion should be targeted at women with GDM risk factors, in particular overweight women, in enhancing women’s PA in the long term and their children’s healthy body composition.

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Response to Comments on: Rowan et al. Metformin in Gestational Diabetes: The Offspring Follow-Up (MiG TOFU): Body Composition at 2 Years of Age. Diabetes Care 2011;34:2279-2284

Diabetes Care ◽

10.2337/dc11-2258 ◽

2012 ◽

Vol 35 (3) ◽

pp. e30-e30 ◽

Cited By ~ 1

Author(s):

J. A. Rowan ◽

E. C. Rush ◽

V. Obolonkin ◽

M. Battin ◽

T. Wouldes ◽

...

Keyword(s):

Body Composition ◽

Gestational Diabetes ◽

Diabetes Care

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Transgenerational effects of maternal obesity and gestational diabetes on offspring body composition and left ventricle mass: the Finnish Gestational Diabetes Prevention Study (RADIEL) 6‐year follow‐up

Diabetic Medicine ◽

10.1111/dme.14089 ◽

2019 ◽

Vol 37 (1) ◽

pp. 147-156 ◽

Cited By ~ 3

Author(s):

L. Litwin ◽

J. K. M. Sundholm ◽

K. Rönö ◽

S. B. Koivusalo ◽

J. G. Eriksson ◽

...

Keyword(s):

Body Composition ◽

Left Ventricle ◽

Gestational Diabetes ◽

Diabetes Prevention ◽

Maternal Obesity ◽

Prevention Study ◽

Transgenerational Effects ◽

Left Ventricle Mass ◽

Diabetes Prevention Study

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Metformin in gestational diabetes: the offspring follow-up (MiG TOFU): body composition and metabolic outcomes at 7–9 years of age

BMJ Open Diabetes Research & Care ◽

10.1136/bmjdrc-2017-000456 ◽

2018 ◽

Vol 6 (1) ◽

pp. e000456 ◽

Cited By ~ 75

Author(s):

Janet A Rowan ◽

Elaine C Rush ◽

Lindsay D Plank ◽

Jun Lu ◽

Victor Obolonkin ◽

...

Keyword(s):

Body Composition ◽

Adipose Tissue ◽

Gestational Diabetes ◽

Body Fat ◽

Glycosylated Hemoglobin ◽

Abdominal Fat ◽

Metabolic Outcomes ◽

Body Fat Percent ◽

Magnetic Resonance Imaging Mri ◽

Design And Methods

ObjectiveTo compare body composition and metabolic outcomes at 7–9 years in offspring of women with gestational diabetes (GDM) randomized to metformin (±insulin) or insulin treatment during pregnancy.Research design and methodsChildren were assessed at 7 years in Adelaide (n=109/181) and 9 years in Auckland (n=99/396) by anthropometry, bioimpedance analysis (BIA), dual-energy X-ray absorptiometry (DXA), magnetic resonance imaging (MRI) (n=92/99) and fasting bloods (n=82/99).ResultsIn the Adelaide subgroup, mothers were similar at enrollment. Women randomized to metformin versus insulin had higher treatment glycemia (p=0.002) and more infants with birth weight >90th percentile (20.7% vs 5.9%; p=0.029). At 7 years, there were no differences in offspring measures. In Auckland, at enrollment, women randomized to metformin had a higher body mass index (BMI) (p=0.08) but gained less weight during treatment (p=0.07). Offspring birth measures were similar. At 9 years, metformin offspring were larger by measures of weight, arm and waist circumferences, waist:height (p<0.05); BMI, triceps skinfold (p=0.05); DXA fat mass and lean mass (p=0.07); MRI abdominal fat volume (p=0.051). Body fat percent was similar between treatment groups by DXA and BIA. Abdominal fat percentages (visceral adipose tissue, subcutaneous adipose tissue and liver) were similar by MRI. Fasting glucose, triglyceride, insulin, insulin resistance, glycosylated hemoglobin (HbA1c), cholesterol, liver transaminases, leptin and adiponectin were similar.ConclusionsMetformin or insulin for GDM was associated with similar offspring total and abdominal body fat percent and metabolic measures at 7–9 years. Metformin-exposed children were larger at 9 years. Metformin may interact with fetal environmental factors to influence offspring outcomes.

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