Dr. Bridig Gregg presented “Lactational Programming of Offspring Glucose Homeostasis and Body Composition by Early Postnatal Metformin Exposure” at the 78th Scientific Sessions for the American Diabetes Association(June 22–26) in Orlando, FL.

Doximity discussed the research with Dr. Gregg at ADA 2018. Below is a transcript of the video interview.

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Doximity: What do you think is the greatest impact this finding has for ensuring long-term metabolic health?

Gregg: Some of the findings of the research that I'm presenting here at ADA are that when we expose mother mice to metformin while they're lactating, that long-term the offspring have decreased weight, decreased fat mass, improved insulin sensitivity and changes in their intestinal microbiome.

I think one important implication of this [finding] is that even in the early postnatal period, there's a critical window that's important for programming long term metabolic outcomes in offspring.

Doximity: Did you find any negative side effects or implications of this treatment?

Gregg: In my work, I have not. But I would like to caution that these kind of exposures can have effects on all different tissues on the animal; these are whole body exposures. I've particularly looked at the metabolic tissues, so I haven't focused, for instance, on neural development or cardiovascular development. There are a lot of other tissues that could be affected here that I have not deliberately studied at this point.

I would say a couple other cautions: One is that there have been a couple of human clinical studies looking at outcomes of mothers who receive metformin during the intrauterine development period. What they find is that offspring actually have an increased risk of obesity or adiposity at age four.

I want to caution that it's sometimes hard to directly translate these animal experiments to humans and that these windows are a little bit different in humans and in animals. For instance, in utero development of fat, it typically happens toward the end of pregnancy and that pattern of development is different in mice. Early neonatal mice might be somewhat more like premature humans; it's a little hard to directly translate what I'm doing in that sense.

Doximity: What is the one thing you'd want other clinicians to understand about this study?

Gregg: What I think is really important about these studies is to point out that that early postnatal period is still a critical period of development. I think that the intrauterine window has been really well studied and we all understand the critical importance of different stressors during the intrauterine window, but I'd like to point out that the mom's metabolic state during the early postnatal period is also really important for how the offspring develop.