Maternal and paternal transmission of type 2 diabetes: influence of diet, lifestyle and adiposity


Ali Abbasi, MD, Department of Epidemiology, University Medical Center Groningen, Hanzeplein 1, PO Box 30.001, 9700 RB Groningen, the Netherlands.
(fax: 0031 50 361 4493; e-mail:


Abstract.  Abbasi A, Corpeleijn E, van der Schouw YT, Stolk RP, Spijkerman AMW, van der A DL, Navis G, Bakker SJL, Beulens JWJ (University Medical Center Groningen, Groningen; University Medical Centre Utrecht, Utrecht; and National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands) Maternal and paternal transmission of type 2 diabetes: influence of diet, lifestyle and adiposity. J Intern Med 2011; 270: 388–396.

Objective.  Transmission of family history of type 2 diabetes to the next generation is stronger for maternal than paternal diabetes in some populations. The aim of the present study was to investigate whether this difference is explained by diet, lifestyle factors and/or adiposity.

Methods.  We analysed 35 174 participants from the Dutch contribution to the European Prospective Investigation into Cancer and Nutrition, a prospective population-based cohort (aged 20–70 years) with a median follow-up of 10.2 years. Parental history of diabetes was self-reported. Occurrence of diabetes was mainly identified by self-report and verified by medical records.

Results.  Amongst 35 174 participants, 799 incident cases of diabetes were observed. In age- and sex-adjusted analyses, hazard ratio (HR) and 95% confidence intervals (CIs) for diabetes by maternal and paternal diabetes were 2.66 (2.26–3.14) and 2.40 (1.91–3.02), respectively. Maternal transmission of risk of diabetes was explained by diet (9.4%), lifestyle factors including smoking, alcohol consumption, physical activity and educational level (7.8%) and by adiposity, i.e. body mass index and waist and hip circumference (23.5%). For paternal transmission, the corresponding values were 2.9%, 0.0% and 9.6%. After adjustment for diet, lifestyle factors and adiposity, the HRs for maternal (2.20; 95% CI, 1.87–2.60) and paternal (2.23; 95% CI, 1.77–2.80) transmission of diabetes were comparable.

Conclusions.  Both maternal and paternal diabetes are associated with increased risk of type 2 diabetes, independently of diet, lifestyle and adiposity. The slightly higher risk conferred by maternal compared to paternal diabetes was explained by a larger contribution of diet, lifestyle factors and adiposity.