Mom's Gestational Diabetes Ups Type 1 Diabetes Risk in Kids

Medscape
17 Apr, 2019 ,

According to results of a large observational cohort study, children with mother's having a history of Gestational Diabetes are at two times more risk of developing Type 1 DM by 22 years of age. This study stresses upon the need for evaluating every child with positive history of Gestational Diabetes in mother showing suspected symptoms of Diabetes. 

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Children and youth whose mothers had gestational diabetes were almost twice as likely as their peers to develop diabetes by age 22, according to results of a large observational cohort study in Quebec.

And we can infer that incident diabetes at this age was largely type 1, senior author Kaberi Dasgupta, MD, McGill University, Montreal, Quebec, Canada, told Medscape Medical News.

A previous Swedish study showed that children and youth whose mothers had either gestational diabetes or type 2 diabetes had a heightened risk of diabetes onset by age 22.

Now the current study is the first to show that gestational diabetes alone is associated with type 1 diabetes in children and youth, Dasgupta said, and this risk was higher in adolescents (a 2.5-fold increased risk) than in younger children (a 40% increased risk).

The study by Andrea L. Blotsky, MD, McGill University, and colleagues was published April 15 in the Canadian Medical Association Journal.

Type 1 diabetes and diabetes in general are rare in children and the symptoms may be missed, Dasgupta noted.

Children or teens, she said, "may be a bit thirsty...a bit tired...peeing a bit more, but they're not really perceiving it as abnormal. And suddenly it gets really bad and they wind up hospitalized because they have a crisis like diabetic ketoacidosis."

She continued, "We know that [a family history of] either type 1 or type 2 diabetes is a risk factor for diabetes in kids...but now we can add gestational diabetes to that group of things to take in your history."

If a child develops symptoms of diabetes and his or her mom had gestational diabetes, "expand your possibilities in terms of testing, because it's nothing to test for [diabetes], but it's a big deal to miss it."

Does Gestational Diabetes Impact Pediatric Diabetes?

Previously, the researchers showed in a large retrospective cohort that gestational diabetes and gestational hypertension predicted subsequent risk of incident diabetes, hypertension, and cardiovascular disease or mortality in mothers.

The current study aimed to examine the link between gestational diabetes and pediatric diabetes in the same cohort.

Using a public health insurance database in the province of Quebec, researchers identified 36,590 mothers aged 20 to 44 who gave birth to a single child between 1990 and 2002 and who developed gestational diabetes.

They then matched them with similar women who did not have gestational diabetes and looked for diabetes in the children between 1990 and 2012.

A higher proportion of mothers with gestational diabetes were of non-European origin (23% vs 18%), did not graduate from high school (26% vs 19%), were from the lowest socioeconomic quintile, had a previous live birth (50% vs 28%), or had an autoimmune disease (30% vs 27%).