Sidell M, Martinez MP, Chow T, et al. - A clinical cohort was examined for longitudinal BMI trajectory from birth to age 10 years after exposure to maternal pre‐existing type 1 (T1D), type 2 (T2D), gestational diabetes managed with or without anti‐diabetes medication, and no diabetes during pregnancy. From a population‐based integrated healthcare system, they obtained data 218,227 singleton children born in 2008‐2015 for inclusion. Of these children, 537 exposed to maternal T1D, 7,836 to T2D, 6,982 to medicated GDM and 12,576 to unmedicated GDM. Significantly lower BMI was recorded at 6‐months after birth for children in all diabetes exposed groups compared with no diabetes. Beginning at nearly age 2.5 years, T1D, T2D and medicated GDM groups had significantly higher BMI compared with the no diabetes group. At age 3, separation of the growth pattern began with highest BMI in T1D and T2D groups, followed by medicated GDM, unmedicated GDM, and the no diabetes groups. By age 7, significantly higher BMI was recorded for the unmedicated GDM group compared with the no diabetes group. T1D and T2D groups had generally comparable adjusted BMI for all ages. These findings suggest the existence of a hierarchical BMI growth pattern in offspring exposed to different types of diabetes during pregnancy after adjusting for important covariates, initiating as early as age 3 years.