# Level and timing of diabetic hyperglycemia in utero: the transgenerational effect on adult morbidity (TEAM Study)

> **NIH NIH R01** · CINCINNATI CHILDRENS HOSP MED CTR · 2021 · $642,284

## Abstract

Project Summary / Abstract
Exposure to maternal diabetes mellitus, regardless of type, in utero increases the risk of obesity, insulin
resistance, diabetes, renal compromise and cardiovascular disease in offspring. However, the level and
timing of hyperglycemic exposure during fetal development, triggering these remote, transgenerational
morbid outcomes, remain unknown. The identification of offspring at risk, and of the optimal times to initiate
potential preventive measures are each critical for improving the health outcomes of these vulnerable fetuses.
Over the past half century, type 1 diabetes control during pregnancy has improved exponentially, resulting in
decreased incidence of congenital malformations (most commonly cardiac) and of perinatal mortality from 17%
and16%, respectively, to rates which now approach those in non-diabetic pregnancy. However, other offspring
outcomes, including obesity, metabolic, and preclinical cardiovascular disease have failed to decline. It is
critical to rapidly and directly determine specific contributions of the intrauterine environment to these more
subtle pathophysiologies and preclinical diseases affecting adult offspring of women with type 1 diabetes
during pregnancy. This proposal, capitalizing on a unique dataset and our ability to re-study an established
cohort, will address this key gap, directly inform clinical management, and alert the pregnant woman herself,
regarding the lifetime consequences for her offspring due to hyperglycemic excursions during gestation.
 The central hypothesis for this proposal is that adults exposed in utero to hyperglycemia, will have
increased risk of obesity, insulin resistance, diabetes, and renal and cardiovascular compromise. To test this
hypothesis we will complete the following specific aims. Specific Aim 1: To demonstrate the
transgenerational effect of the hyperglycemic intrauterine environment on metabolic health of adult
offspring of women with type 1 diabetes. We will identify sensitive gestational periods of hyperglycemia
predictive of specific metabolic morbidities in the adult offspring. Specific Aim 2: To demonstrate the
transgenerational effect of the hyperglycemic intrauterine environment on cardiac and peripheral
vascular structure and function in adult offspring of women with type 1 diabetes. We will determine if
cardiovascular compromise in the adult offspring may be predicted by an identified maternal glycemic profile,
characterizing both level of glucose control and variability.
 This transgenerational cohort study will apply innovative statistical approaches to relate timing, level
and variability of maternal glycemia to morbidity in adult offspring of women with type 1 diabetes. The
remarkable granularity of data collected prospectively during the index pregnancies, combined with new data
from the adult offspring and our novel statistical methods, will enable us to identify components of the
intrauterine glycemic environment that contribute to ...

## Key facts

- **NIH application ID:** 10246293
- **Project number:** 5R01DK109956-05
- **Recipient organization:** CINCINNATI CHILDRENS HOSP MED CTR
- **Principal Investigator:** Katherine A Bowers
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $642,284
- **Award type:** 5
- **Project period:** 2017-09-14 → 2023-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10246293

## Citation

> US National Institutes of Health, RePORTER application 10246293, Level and timing of diabetic hyperglycemia in utero: the transgenerational effect on adult morbidity (TEAM Study) (5R01DK109956-05). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10246293. Licensed CC0.

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