Children of obese mums at higher diabetes risk

University of Edinburgh | June 2019 |Children of obese mums at higher diabetes risk

New research indicates that babies who are born to mothers with obesity have a higher risk factor for developing type 2 diabetes in later life. The study also reports that being overweight in pregnancy also increases the child’s diabetes risk by a half. 

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The experts behind the research analysed data from the birth records of 100000 children born in Aberdeen during 1950 and 2011 and linked them with the national register for diagnosed diabetes in Scotland. Figures revealed around one quarter of women were overweight during pregnancy over the 60-year period. One in ten were obese, with a body mass index (BMI) greater than 40.

Offspring whom mums were overweight or obese during pregnancy had an associated risk factor of between 1.4 and 3.5-fold increased incidence.

The study indicates that the proportion of obese mothers increased five-fold from around one in 30 during the 1950s to almost one in six between 2000 and 201 (Source: University of Edinburgh)

Read press release in full from University of Edinburgh

Journal article Consequences of being overweight or obese during pregnancy on diabetes in the offspring: a record linkage study in Aberdeen, Scotland

Full reference: Lahti-Pulkkinen, et al. | 2019| Consequences of being overweight or obese during pregnancy on diabetes in the offspring: a record linkage study in Aberdeen, Scotland| Diabetologia| 1-8.

Abstract

Aims/hypothesis

Maternal obesity in pregnancy is associated with cardiovascular disease and mortality rate in the offspring. We aimed to determine whether maternal obesity is also associated with increased incidence of type 2 and type 1 diabetes in the offspring, independently of maternal diabetes as a candidate mechanistic pathway.

 

Methods

Birth records of 118,201 children from 1950 to 2011 in the Aberdeen Maternity and Neonatal Databank were linked to Scottish Care Information–Diabetes, the national register for diagnosed diabetes in Scotland, to identify incident and prevalent type 1 and type 2 diabetes up to 1 January 2012. Maternal BMI was calculated from height and weight measured at the first antenatal visit. The effect of maternal obesity on offspring outcomes was tested using time-to-event analysis with Cox proportional hazards regression to compare outcomes in offspring of mothers in underweight, overweight or obese categories of BMI, compared with offspring of women with normal BMI.

 

Results

Offspring of obese (BMI more than or equal to 30 kg/m2) and overweight (BMI 25–29.9 kg/m2) mothers had an increased hazard of type 2 diabetes compared with mothers with normal BMI, after adjustment for gestation when weight was measured, maternal history of diabetes before pregnancy, maternal history of hypertension, age at delivery, parity, socioeconomic status, and sex of the offspring: HR 3.48 (95% CI 2.33, 5.06) and HR 1.39 (1.06, 1.83), respectively.

 

Conclusions/interpretation

Maternal obesity is associated with increased incidence of type 2 diabetes in the offspring. Evidence-based strategies that reduce obesity among women of reproductive age and that might reduce the incidence of diabetes in their offspring are urgently required.

 

National Diabetes Audit

The National Diabetes Audit (NDA) measures the effectiveness of diabetes healthcare against NICE Clinical Guidelines and NICE Quality Standards, in England and Wales. The NDA collects and analyses data for use by a range of stakeholders to drive changes and improvements in the quality of services and health outcomes for people with diabetes.

This report details the findings for the 2017-18 audit. The audit collected data during May and June 2018, for the period 01 January 2017 to 31 March 2018 and contains the full key findings, recommendations and new analysis relating to cardiovascular disease (CVD) risk, including new treatment targets showing statin prescriptions for CVD risk reduction.

Full detail at NHS Digital

Type 2 diabetes in midlife and risk of cerebrovascular disease in late life: a prospective nested case−control study in a nationwide Swedish twin cohort

 Yang, R. et al | 2019| Type 2 diabetes in midlife and risk of cerebrovascular disease in late life: a prospective nested case−control study in a nationwide Swedish
twin cohort| Diabetologia |https://doi.org/10.1007/s00125-019-4892-3

Research from Sweden studied the association between diabetes mellitus type 2 in midlife (40-59 years) and cerebrovascular disease in late life. The study explored the incidence of CBD in over 300,000 twins who were CBD-free at the outset of the study. 

Midlife type 2 diabetes is significantly associated with increased risk of cerebral infarction and occlusion of cerebral arteries, but not intracerebral haemorrhage or subarachnoid haemorrhage in late life. The researchers report that genetic and early-life familial environmental factors do not appear to account for the type 2 diabetes.

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The findings of this study are now published in Diabetologia 

In the news:

OnMedica Possible link between diabetes and cerebrovascular disease

 

Abstract

Aims/hypothesis

We aimed to examine the association between midlife type 2 diabetes mellitus and cerebrovascular disease (CBD) in late life, and further to explore whether genetic and early-life familial environmental factors (such as shared childhood socioeconomic status and adolescent environment) play a role in this association.

Methods

In this prospective nested case−control study based on the Swedish Twin Registry, 33,086 twin individuals who were born in 1958 or earlier and were CBD-free before the age of 60 were included. Midlife (40–59 years) type 2 diabetes was ascertained from self-report, the National Patient Registry (NPR) and glucose-lowering medication use. CBD diagnosis (cerebral infarction, occlusion of cerebral arteries, subarachnoid haemorrhage, intracerebral haemorrhage and unspecified CBD) and onset age were identified from the NPR. Late-life CBD was defined as CBD onset aged 60 years or over. Generalised estimating equation (GEE) models were used to analyse unmatched case−control data (adjusted for the clustering of twins within a pair). Conditional logistic regression was used in co-twin matched case−control analyses in CBD-discordant twin pairs.

Results

Of all the participants, 1248 (3.8%) had midlife type 2 diabetes and 3121 (9.4%) had CBD in late life. In GEE models adjusted for age, sex, education, BMI, smoking, alcohol consumption, marital status, hypertension and heart disease, the ORs of type 2 diabetes were 1.29 for cerebral infarction, 2.03 for occlusion of cerebral arteries, 0.52  for subarachnoid haemorrhage and 0.78  for intracerebral haemorrhage. In multi-adjusted conditional logistic regression, the OR of the type 2 diabetes–cerebral infarction association was 0.96. The differences in ORs from the GEE and co-twin control analyses were not statistically significant.

Conclusions/interpretation

Midlife type 2 diabetes is significantly associated with increased risk of cerebral infarction and occlusion of cerebral arteries, but not intracerebral haemorrhage or subarachnoid haemorrhage in late life. Genetic and early-life familial environmental factors do not appear to account for the type 2 diabetes–cerebral infarction association, but further clarification is needed.

The full article is available from Diabetologia 

Type 2 diabetes in midlife and risk of cerebrovascular disease in late life: a prospective nested case−control study in a nationwide Swedish twin cohort