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An unwelcome inheritance: childhood obesity after diabetes in pregnancy – published online 13/07/2023

Meek graphical abstract

Claire L. Meek

Over 20 million infants per year are born to mothers with diabetes, and are at high risk of childhood obesity, attributed primarily to developmental influences in utero. The early onset of obesity in children with existing environmental and genetic susceptibilities to diabetes should be a major public health concern. In this issue, Claire Meek (https://doi.org/10.1007/s00125-023-05965-w) summarises the current understanding of the pathophysiology of obesity in children after intrauterine exposure to maternal hyperglycaemia. Meek proposes a new hypothesis for the mechanisms underlying childhood obesity in infants born to mothers with diabetes, involving subtle upregulation of de novo lipogenesis pathways and pancreatic beta cell function, which is initiated in utero and persists into childhood. The author also highlights possible opportunities for intervention and concludes that effective intervention will require a new focus on maternal health before, during and after pregnancy to halt the intergenerational cycle of obesity. The figure from this review is available as a downloadable slide.

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