Wicklow BA, et al. - Authors gauged the relationship of in utero exposure to gestational diabetes and type 2 diabetes, stratified by First Nations (FN) status, with the development of type 2 diabetes in offspring. Offspring risk demonstrated important differences exist based on type of diabetes exposure in utero.

Methods

• Experts derrived this cohort study from the linkage of a pediatric diabetes clinical database and a population-based research data repository in Manitoba, Canada.
• They identified the mother-infant dyads with a hospital birth or midwifery report in the data repository between April 1, 1984, and April 1, 2008, the dates of analysis were August through December 2017.
• They excluded the children identified with type 1 diabetes, monogenic diabetes, or secondary diabetes.
• Maternal gestational diabetes or type 2 diabetes and FN status were the primary exposures.
• Incident type 2 diabetes in offspring by age 30 years was the primary outcome.

Results

• Findings suggested that in this cohort study of 467,850 offspring (mean follow-up, 17.7 years; 51.2% male), an association of FN status and diabetes exposure with incident type 2 diabetes in offspring after adjustment for sex, maternal age, socioeconomic status, birth size, and gestational age was seen.
• A greater risk was conferred by type 2 diabetes exposure to offspring compared with gestational diabetes exposure (3.19 vs 0.80 cases per 1000 person-years,P < .001).
• Results demonstrated that compared with no diabetes exposure, any diabetes exposure accelerated the time to the development of type 2 diabetes in offspring by a factor of 0.74 (95% CI, 0.62-0.90) for gestational diabetes and a factor of 0.50 (95% CI, 0.45-0.57) for type 2 diabetes.
• Compared with non-FN offspring, first Nations offspring had a higher risk (0.96 vs 0.14 cases per 1000 person-years,P < .001).
• Compared with non-FN offspring, accelerated type 2 diabetes onset by a factor of 0.52 (95% CI, 0.49-0.55) was seen in first Nations offspring had.
• Authors noted that neither interaction between FN and type 2 diabetes (0.92; 95% CI, 0.80-1.05) nor interaction between FN and gestational diabetes (0.97; 95% CI, 0.77-1.20) was significant (P=.21 and P=.75, respectively).