OBJECTIVEdTo assess associations of gestational diabetes, existing diabetes, and glycosuria with adiposity and cardiometabolic risk factors in offspring at adolescence.RESEARCH DESIGN AND METHODSdMultivariable regression analyses were conducted in a prospective pregnancy cohort (n = 2,563-4,198 for different outcomes). Obstetric data were abstracted from clinical records. Offspring outcomes were assessed at mean age 15.5 years. Compared with those lost to follow-up, participants included in the analysis were of higher socioeconomic position. Outcomes included BMI, waist circumference, fat mass determined by dual-energy X-ray absorptiometry scan, systolic and diastolic blood pressure (sBP and dBP, respectively), fasting glucose, insulin, lipids, and C-reactive protein (CRP).RESULTSdMaternal existing diabetes, gestational diabetes, and glycosuria were associated with higher offspring BMI and fat mass (z scores); however, this effect was attenuated in the confounder-adjusted model, and the CIs included the null value. Existing diabetes and gestational diabetes were associated with higher offspring fasting glucose levels ( CONCLUSIONSdMaternal pregnancy glycosuria, gestational diabetes, and existing diabetes show some associations with higher offspring fasting glucose and insulin assessed in adolescence but are not clearly associated with a wider range of cardiometabolic risk factors. 35:63-71, 2012 D etailed analyses from Pima Indian populations have demonstrated that fetal exposure to maternal diabetes in utero increases the risk of obesity and type 2 diabetes for offspring in later life (1). Fewer studies examine these associations in non-Pima populations, in whom the prevalence of obesity and diabetes is much lower. A recent systematic review and meta-analysis identifies nine such studies and concludes that maternal diabetes is associated with increased offspring BMI (2). The authors highlighted that only three of the nine studies had adjusted for maternal prepregnancy or early pregnancy BMI and that pooling results from these studies after adjustment for maternal BMI suggested that this was a major confounder for the association with offspring BMI. However, there was evidence of marked heterogeneity between results from these three studies, potentially reflecting the different underlying types of diabetes examined and the prepubertal ages examined (2). Furthermore, the review does not include a recently published very large sibling study in Swedish men that similar to studies in the Pima, supports an intrauterine mechanism linking maternal diabetes in pregnancy with offspring BMI that is not confounded by maternal early pregnancy BMI (3). In that study, mean BMI at age 18 years of younger brothers born after their mother was diagnosed with diabetes in pregnancy was greater than their older brothers' mean BMI who were born before this diagnosis (3). It is notable that to date, few studies have examined associations with other offspring cardiometabolic risk factors and whether associations are mediated by the ...