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April 15, 2019
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Gestational diabetes doubles risk for incident diabetes into young adulthood

Children of mothers with gestational diabetes are at higher risk for developing diabetes during childhood and adolescence than those born to mothers without the condition, according to findings presented in the Canadian Medical Association Journal.

“So very few young people will ever develop diabetes before 22 years of age, even if their mother had gestational diabetes,” Kaberi Dasgupta, MD, MSc, associate professor of medicine and physician scientist at the Centre for Outcomes Research and Evaluation at the Research Institute of the McGill University Health Centre in Montreal, told Endocrine Today. “However, if kids or young people develop some of the signs of diabetes (urinating a lot, being very thirsty, losing weight), they, their parents and their health care providers should consider the possibility of diabetes, particularly if their parents have diabetes or — as our study suggests — if their moms had gestational diabetes. In most cases, they won’t have diabetes, but it is important to consider as it is a diagnosis we don’t want to miss.”

Dasgupta and colleagues examined health administrative data and birth and death registries from Quebec and identified 36,590 women with gestational diabetes who gave birth between April 1990 and Dec. 31, 2007. These women and their children were matched to the same number of women without gestational diabetes who gave birth during the same period as identified by the health administrative and birth registry data. Children were then followed through March 2012.

Children of mothers with gestational diabetes had a higher rate of diabetes incidence (4.52 per 10,000 person-years; 95% CI, 4.47-4.57) than children of mothers without the condition (2.41 per 10,000 person-years; 95% CI, 2.37-2.46). Furthermore, the researchers identified a positive association between gestational diabetes of the mother and diabetes development in the first 22 years of life in their children (adjusted HR = 1.77; 95% CI, 1.41-2.22). The positive association remained when looking at birth to age 12 years (aHR = 1.43; 95% CI, 1.09-1.89) and age 12 to 22 years (aHR = 2.53; 95% CI, 1.67-3.85).

From age 12 to 22 years, HRs for girls (aHR = 1.86; 95% CI, 1.28-2.7), those with a gestational age less than 32 weeks (HR = 2.97; 95% CI, 1.19-7.42) and those born to mothers who had been pregnant before (aHR = 1.7; 95% CI, 1.2-2.54) indicated a positive association between these factors and diabetes development, the researchers reported.

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“We expected gestational diabetes in mothers to be linked to type 2 in kids. Because type 2 in kids is not common, we expected a small link,” Dasgupta said. “However, we found a strong link: Children of women with gestational diabetes were twice as likely to develop diabetes before 22 years of age than children of women without gestational diabetes. This implies a link between gestational diabetes in mothers and type 1 in kids. We should note that we could not distinguish between type 1 and type 2 in our data — we just know that the kids have diabetes. However, we know from other studies that over 90% of the diabetes in kids would be type 1.”– by Phil Neuffer

Disclosures: The authors report no relevant financial disclosures.

Sources/Disclosures

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Source:

Blotsky AL, et al. CMAJ. 2019;doi:10.1503/cmaj.181001.