ESPEYB21 12. Type 2 Diabetes, Metabolic Syndrome and Lipids Pregnancy and Youth Onset T2D (2 abstracts)
12.8. Impact of youth onset type 2 diabetes during pregnancy on microvascular and cardiac outcomes
Tryggestad JB , Drews KL , Mele L , Arslanian S , Chernausek SD , Escaname EN , Geffner M , Isganaitis E , Sprague J & Kelsey MM; TODAY Study Group.
Diabetes Res Clin Pract. 2023 Sep;203:110876. doi:10.1016/j.diabres.2023.110876.
Brief Summary: This observational study showed that pregnancy increases the risk of hyperfiltration in women with youth-onset T2D, but not other micro or macrovascular complications.
Comment: This study examined whether pregnancy exacerbates health outcomes in young women with T2D, particularly by testing for changes in the occurrence of microvascular and macrovascular complications. Previous findings showed that women in their fourth decade experience a notable increase in complications following pregnancy. Given the aggressive nature of youth-onset T2D, one might expect a similar impact of pregnancy on the incidence of complications. Neuropathy and nephropathy were assessed annually. Retinopathy, echocardiography, and arterial stiffness were assessed twice during the study.
Among women in the TODAY study, 116 reported a pregnancy lasting 20 weeks or more, with 67 experiencing a single pregnancy and 49 having multiple pregnancies. The average age at first pregnancy was 21.6 years, and the mean duration of diabetes was 8 years. Their data were compared to that of 291 nulliparous women with youth-onset T2D.
The encouraging news is that no difference was found in the rates of retinopathy, neuropathy, or macro- and microalbuminuria between women with and without a history of pregnancy. Additionally, pregnancy history did not affect echocardiographic measures or arterial stiffness when comparing pre- and post-pregnancy data.
However, women who had been pregnant were at higher risk of developing hyperfiltration, an early marker of nephropathy, (odds ratio: 2.76; CI: 1.38-5.49) compared to those who had not been pregnant. The median and interquartile range for the onset of nephropathy after pregnancy were: macroalbuminuria developed after 285 days (126–1255), microalbuminuria after 549 days (129–1607), and hyperfiltration after 375 days (302–935.5).
Volume 21
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ESPE Yearbook of Paediatric Endocrinology
ISSN 1662-4009 (Online)
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