Children born to mothers who had gestational diabetes were more likely to develop diabetes during childhood and adolescence, according to a nationwide South Korean cohort study announced by the Korea Disease Control and Prevention Agency. The association was strongest when the motherโs condition had required insulin treatment during pregnancy. Researchers found up to a 4.3-fold higher risk of type 2 diabetes and a 1.9-fold higher risk of type 1 diabetes in that group compared with children whose mothers did not have gestational diabetes.
The study used National Health Insurance Service data for 3,491,680 mother-child pairs. It included children born from 2009 through 2018 and followed them through the end of 2022, for a median of 9.5 years and a maximum of 14 years. Researchers divided mothers into three groups: no gestational diabetes, gestational diabetes managed without insulin, and gestational diabetes treated with insulin. They then compared the occurrence of type 1 and type 2 diabetes among the children.
Children whose mothers had gestational diabetes but did not require insulin had a 1.28-fold higher risk of type 2 diabetes than those in the group without gestational diabetes. No clear association with type 1 diabetes was identified for this non-insulin group. Among children whose mothers required insulin, however, the risk was 4.3 times higher for type 2 diabetes and 1.9 times higher for type 1 diabetes.
Risk rose most in the insulin-treated group
The findings show an association rather than proving that gestational diabetes directly caused diabetes in the children. Insulin treatment should also not be interpreted as the source of the higher risk. In the study, the need for insulin distinguished mothers whose blood glucose could not be managed sufficiently through diet and physical activity alone, making it an indicator of a higher-risk pregnancy group.
The National Institute of Health said the results reinforce the importance of managing blood glucose during pregnancy and continuing health attention after birth. It advised families, particularly those in the insulin-treated group, to monitor childrenโs weight and blood glucose as they grow. The study also noted that mothers usually return to normal blood glucose after delivery but remain at elevated risk of developing type 2 diabetes, supporting continued care for both mother and child.