Maternal diabetes linked to poor type 2 diabetes outcomes in children
medwireNews: Maternal history of diabetes is associated with accelerated loss of glycemic control and an increased risk for adverse outcomes among youth with type 2 diabetes, suggests an analysis of data from the TODAY trial.
As reported at the virtual ADA 81st Scientific Sessions, children and adolescents aged 10–17 years with type 2 diabetes who had mothers (n=177), fathers (n=72), or both parents (n=79) with diabetes had significantly higher average glycated hemoglobin (HbA1c) levels at baseline than those with no parental history of diabetes (n=158), at 6.1%, 6.0%, and 6.2%, respectively, versus 5.8% (43, 42, and 44 vs 40 mmol/mol).
During an average follow-up of 10.2 years, participants with a maternal history of diabetes during or after pregnancy had a significant 60% higher likelihood of experiencing loss of glycemic control – defined as HbA1c above 8% for more than 6 months – than those without, with cumulative incidence rates of 87 and 88%, respectively, versus 80%. There were no such associations with paternal diabetes, however.
Rachana Shah (Children's Hospital of Philadelphia, Pennsylvania, USA) and team also found that participants with a maternal, but not those with a paternal, history of diabetes had a significantly increased likelihood of developing renal hyperfiltration, as well as “unfavorable vascular indices” including greater heart rate variability.
The presenter concluded that further research is needed to understand “the mechanisms of prenatal exposures […] with the ultimate goal of preventing adverse impacts.”
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