RT Journal Article
SR Electronic
T1 Gestational diabetes associated with incident diabetes in childhood and youth: a retrospective cohort study
JF Canadian Medical Association Journal
JO CMAJ
FD Canadian Medical Association
SP E410
OP E417
DO 10.1503/cmaj.181001
VO 191
IS 15
A1 Blotsky, Andrea L.
A1 Rahme, Elham
A1 Dahhou, Mourad
A1 Nakhla, Meranda
A1 Dasgupta, Kaberi
YR 2019
UL http://www.cmaj.ca/content/191/15/E410.abstract
AB BACKGROUND: Indicators of childhood- and youth-onset diabetes may be useful for early detection of diabetes; there is a known association between composite exposure of parental type 2 diabetes and gestational diabetes mellitus with childhood- and youth-onset diabetes. We examined associations between gestational diabetes mellitus and incidence of childhood- and youth-onset diabetes in offspring.METHODS: Using public health insurance administrative databases from Quebec, Canada, we randomly selected singleton live births with maternal gestational diabetes mellitus (1990–2007) and matched them 1:1 with singleton live births without gestational diabetes mellitus. Follow-up was to Mar. 31, 2012. We examined associations of diabetes in offspring with maternal gestational diabetes mellitus through unadjusted and adjusted Cox proportional hazards models. In secondary analyses, we separately considered age groups ranging from birth to age 12 years, and age 12 to 22 years.RESULTS: Incidence of pediatric diabetes (per 10 000 person-years) was higher in offspring born to mothers with gestational diabetes mellitus (4.52, 95% confidence interval [CI] 4.47–4.57) than in mothers without gestational diabetes mellitus (2.4, 95% CI 2.37–2.46). In an adjusted Cox proportional hazards model, maternal gestational diabetes mellitus was associated with development of pediatric diabetes overall (birth to age 22 yr: hazard ratio [HR] 1.77, 95% CI 1.41–2.22), during childhood (birth to age 12 yr: HR 1.43, 95% CI 1.09–1.89), and in youth (age 12 to 22 yr: HR 2.53, 95% CI 1.67–3.85).INTERPRETATION: Gestational diabetes mellitus is associated with incident diabetes in offspring during childhood and adolescence. Future studies are needed to examine longer-term outcomes in patients with pediatric diabetes with a maternal history of gestational diabetes mellitus, to ascertain how they compare with other patients with childhood- or youth-onset diabetes, in terms of disease severity and outcomes.