Research has long indicated that gestational diabetes is a predictor of type 2 diabetes in mothers. For a study published in the Canadian Medical Association Journal, my colleagues and I assessed the link between gestational diabetes and the development of diabetes in offspring before age 22.
Using public health insurance administrative databases from Quebec, we randomly selected singleton live births with maternal gestational diabetes (1990-2007) and matched them 1:1 with singleton live births without gestational diabetes. Follow-up was through March 2012. We examined associations through unadjusted and adjusted Cox proportional hazards models. In secondary analyses, we separately considered age groups ranging from birth to age 12, and age 12 to 22.
Based on data showing that more than 90% of pediatric diabetes in most of Canada is type 1, we expected to find a small association between gestational diabetes and pediatric diabetes. However, we found a large association: the offspring of mothers with gestational diabetes were nearly twice as likely to develop diabetes before age 22 than the offspring of mothers without gestational diabetes. Our results are consistent with a Swedish study showing that the offspring of mothers with wither type 2 or gestational diabetes were twice as likely to develop type 1 when compared with the offspring of mothers without any diabetes.
One-third to one-quarter of young people with type 1 diabetes present with diabetic ketoacidosis, a medical emergency that requires intensive care. The symptoms of polyuria, polydipsia, and fatigue leading up to this may be dismissed by a young person and their friends and family, delaying diagnosis. While more research is needed to better understand the association between gestational diabetes and type 1 diabetes in offspring, we hope our findings help clinicians shed light on an additional clue that could push families to seek medical attention if symptoms develop.
Rebecca Shover