Importance of maternal history of non-insulin dependent diabetic patients.

Abstract

Objective-To assess the family history ofdiabetes in non-insulin dependent diabetes mellitus with particular emphasis on parental phenotype.Design-Family histories were obtained from an existing computerised database and supplemented by postal questionnaires.Setting-Diabetic service of a provincial teaching hospital.Subjects-A total of 1326 patients with non-insulin dependent diabetes who had been referred to diabetic clinics over the past 10 years and from whom data had been collected for inclusion in the database, of whom 347 had affected first degree relatives. Nineteen non-white patients were excluded because of the differential hereditability of the disease, and 230 (70%) patients with an affected first degree relative responded to the postal questionnaire.Results-Mothers were implicated in significantly more cases than fathers in patients with a single affected parent: 125 mothers and 48 fathers from database; 82 mothers and 34 fathers from postal questionnaire; p<0 001 in both cases.Conclusions-Maternal influences seem to have an important role in the inheritance of non-insulin dependent diabetes. IntroductionThe genetics of non-insulin dependent diabetes mellitus remains an enigma. It is well known that many patients give a positive family history, but attempts to place the disease into the simple mendelian pattern have failed. Furthermore, molecular genetic studies have not been as successful in finding disease markers as in insulin dependent diabetes.' Several recent studies have suggested that intrauterine environment may also predispose to the development of non-insulin dependent diabetes.2 This would further complicate the transmission pattern of the disease by simulating genetic inheritance through maternal transmission. To clarify the genetics of non-insulin dependent diabetes and the role of maternal inheritance we studied the family history of a large number of patients with noninsulin dependent diabetes.

Intrauterine exposure to diabetes conveys risks for type 2 diabetes and obesity: a study of discordant sibships.

“…Previous studies in the Pima Indians have shown a much higher prevalence of both type 2 diabetes and obesity in offspring of women who developed diabetes before or during pregnancy than in the offspring of nondiabetic women or the offspring of women who developed diabetes after delivery (prediabetic women) (2,5). This finding is consistent with the greater frequency of diabetes found in offspring of type 2 diabetic mothers than of type 2 diabetic fathers in Pima Indians (2) and in other populations (13,14). These data suggest that exposure to the intrauterine diabetic environment is an important determinant of type 2 diabetes and obesity in adolescence and young adulthood, in addition to the genetic predisposition presumably present in the offspring of both diabetic and prediabetic women (15).…”

Lack of excess maternal transmission of type 2 diabetes in a Korean population

“…We should also note the possible recall bias [12,16,31] in our study. Although we have no relevant data to address this issue, we do not think that our results were affected by recall bias because of the relatively large sample size and the presence of a normal fasting glucose control group.…”

“…The existence of excess maternal transmission of type 2 diabetes is still in controversial issues. Although the majority of studies suggest that excess maternal transmission occurs [6,7,[11][12][13][14][15][16][17][18][19], however, a few studies refute this finding [20][21][22]. Recently, the Framingham Offspring Study suggested equivalent maternal and paternal effects on risk for offspring diabetes [20].…”

The molecular genetics of non‐insulin‐dependent diabetes mellitus

“…NIDDM seems to have a predominant maternal mode of transmission in Caucasians with a relatively low prevalence of the disease [4]. After adjustment for age (mothers live longer than fathers), NIDDM is one-and-a-half times more prevalent in mothers than in fathers of patients with NIDDM in Scandinavia [5].…”