ESPEYB20 10. Type 2 Diabetes, Metabolic Syndrome and Lipid Metabolism New Drugs for Children with T2DM (5 abstracts)
10.7. Maternal diabetes in youth-onset type 2 diabetes is associated with progressive dysglycemia and risk of complications
Shah RD , Chernausek SD , El Ghormli L , Geffner ME , Keady J , Kelsey MM , Farrell R , Tesfaldet B , Tryggestad JB , Van Name M & Isganaitis E
J Clin Endocrinol Metab. 2023 Apr 13;108(5):1120–1131. doi: 10.1210/clinem/dgac663
Brief summary: This analysis of data from the TODAY study examined the impact of parental diabetes on outcomes in young individuals with T2D during over 12 years of follow-up. This novel observation demonstrates that parental diabetes affects not only earlier T2D onset, but also more rapid long-term progression and more complications.
Comment: This study showed that T2D diagnosis in either parent was associated with younger age at T2D diagnosis in their children, higher HbA1c, and greater risks of impaired β-cell function at diagnosis, and of loss of glycemic control in the first 4 years after diagnosis. However, data are limited regarding the long-term effects of parental diabetes on disease progression and complications in youth-onset T2D.
Among persons with complete data (n=486), T2D in both parents was reported in 16%; T2DM in mothers only, of 36%; and T2DM in fathers only, of 15%. Of the 621 individuals with complete data of maternal diabetes, 35% reported maternal diabetes diagnosed before or during pregnancy, and 16% reported maternal diabetes diagnosed after pregnancy. The 12-year analysis revealed an association of a parent’s history of diabetes, with poorer glycemic control and indicators of autonomic neuropathy, such as heart rate variability in offspring.
In addition, maternal diabetes, whether diagnosed before or after pregnancy, was associated with poor diabetes control, reduced β-cell function, glomerular hyperfiltration and an increased risk of autonomic dysfunction in offspring with youth-onset of T2D. The stronger association between maternal diabetes and the metabolic phenotype may reflect the effect of the in-utero environment, or the mitochondrial genome, which is maternally inherited.
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ESPE Yearbook of Paediatric Endocrinology
ISSN 1662-4009 (Online)
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