Elizabeth A C Sellers1,2, Heather J Dean3,2, Leigh Anne Shafer4, Patricia J Martens5,6, Wanda Phillips-Beck7,8, Maureen Heaman2,5,9, Heather J Prior5,6, Allison B Dart3,2, Jonathan McGavock3,2, Margaret Morris10, Ali A Torshizi4, Sora Ludwig4, Garry X Shen4. 1. Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Manitoba, Canada esellers@exchange.hsc.mb.ca. 2. Children's Hospital Research Institute of Manitoba, Winnipeg, Manitoba, Canada. 3. Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Manitoba, Canada. 4. Department of Internal Medicine, University of Manitoba, Winnipeg, Manitoba, Canada. 5. Manitoba Centre for Health Policy, University of Manitoba, Winnipeg, Manitoba, Canada. 6. Department of Community Health Science, University of Manitoba, Winnipeg, Manitoba, Canada. 7. University of Manitoba, Winnipeg, Manitoba, Canada. 8. Assembly of Manitoba Chiefs, Winnipeg, Manitoba, Canada. 9. Faculty of Nursing, University of Manitoba, Winnipeg, Manitoba, Canada. 10. Department of Obstetrics and Gynecology, University of Manitoba, Winnipeg, Manitoba, Canada.
Abstract
OBJECTIVE: Type 2 diabetes is increasing in children worldwide, with Canadian First Nations (FN) children disproportionally affected. The prevalence of gestational diabetes mellitus (GDM) also is increasing. The objective of this study was to evaluate the impact of GDM exposure in utero and FN status on the subsequent risk of type 2 diabetes in offspring in the first 30 years of life. RESEARCH DESIGN AND METHODS: In this population-based historical prospective cohort study, we used administrative databases linked to a clinical database to explore the independent association and interaction between GDM and FN status on the subsequent development of type 2 diabetes in offspring. RESULTS: Among 321,008 births with a median follow-up of 15.1 years, both maternal GDM and FN status were independently associated with subsequent risk of type 2 diabetes in offspring in the first 30 years of life (hazard ratio 3.03 [95% CI 2.44-3.76; P < 0.0001] vs. 4.86 [95% CI 4.08-5.79; P < 0.0001], respectively). No interaction between GDM and FN status on type 2 diabetes risk was observed. FN status had a stronger impact on the development of type 2 diabetes in offspring than GDM. CONCLUSIONS: GDM is an important modifiable risk factor for type 2 diabetes, and its prevention may reduce the prevalence of subsequent type 2 diabetes in offspring. This study adds unique and rigorous evidence to the global public health debate about the impact of GDM on the long-term health of offspring.
OBJECTIVE:Type 2 diabetes is increasing in children worldwide, with Canadian First Nations (FN) children disproportionally affected. The prevalence of gestational diabetes mellitus (GDM) also is increasing. The objective of this study was to evaluate the impact of GDM exposure in utero and FN status on the subsequent risk of type 2 diabetes in offspring in the first 30 years of life. RESEARCH DESIGN AND METHODS: In this population-based historical prospective cohort study, we used administrative databases linked to a clinical database to explore the independent association and interaction between GDM and FN status on the subsequent development of type 2 diabetes in offspring. RESULTS: Among 321,008 births with a median follow-up of 15.1 years, both maternal GDM and FN status were independently associated with subsequent risk of type 2 diabetes in offspring in the first 30 years of life (hazard ratio 3.03 [95% CI 2.44-3.76; P < 0.0001] vs. 4.86 [95% CI 4.08-5.79; P < 0.0001], respectively). No interaction between GDM and FN status on type 2 diabetes risk was observed. FN status had a stronger impact on the development of type 2 diabetes in offspring than GDM. CONCLUSIONS: GDM is an important modifiable risk factor for type 2 diabetes, and its prevention may reduce the prevalence of subsequent type 2 diabetes in offspring. This study adds unique and rigorous evidence to the global public health debate about the impact of GDM on the long-term health of offspring.
Authors: Brandy A Wicklow; Elizabeth A C Sellers; Atul K Sharma; Kristine Kroeker; Nathan C Nickel; Wanda Philips-Beck; Garry X Shen Journal: JAMA Pediatr Date: 2018-08-01 Impact factor: 16.193
Authors: Laetitia Guillemette; Brandy Wicklow; Elizabeth A C Sellers; Allison Dart; Garry X Shen; Vernon W Dolinsky; Joseph W Gordon; Davinder S Jassal; Nathan Nickel; Todd A Duhamel; Dan Chateau; Heather J Prior; Jonathan McGavock Journal: CMAJ Date: 2020-09-28 Impact factor: 8.262
Authors: Rayzel Shulman; Morgan Slater; Shahriar Khan; Carmen Jones; Jennifer D Walker; Kristen Jacklin; Michael E Green; Eliot Frymire; Baiju R Shah Journal: CMAJ Open Date: 2020-01-28