TY - JOUR
T1 - Comparing the different phenotypes of diabetes in pregnancy
T2 - are outcomes worse for women with young-onset type 2 diabetes compared to type 1 diabetes?
AU - Zhen, Xi May
AU - Ross, Glynis
AU - Gauld, Amanda
AU - Nettel-Aguirre, Alberto
AU - Noonan, Stephanie
AU - Constantino, Maria
AU - Sweeting, Arianne
AU - Harding, Anna Jane
AU - Mackie, Adam
AU - Chatila, Hend
AU - McGill, Margaret
AU - Middleton, Timothy
AU - Wu, Ted
AU - Twigg, Stephen
AU - Wong, Jencia
N1 - Publisher Copyright:
© 2024
PY - 2024/11
Y1 - 2024/11
N2 - Aims: Pregnancies are increasingly affected by young-onset type 2 diabetes mellitus (YT2DM), an aggressive phenotype associated with a higher vascular risk profile compared to type 1 diabetes mellitus (T1DM). We compared pregnancy outcomes to illuminate areas where differing management guidance might be needed. Methods: This retrospective single-centre study (2010 2019) included 259 singleton pregnancies affected by pregestational T1DM (N = 124) or YT2DM (N = 135) diagnosed at < 40 years. Primary outcomes included preterm delivery, large for gestational age (LGA) infants, and pre-eclampsia. Results: The YT2DM cohort were older, with more obesity, greater apparent sociodemographic disadvantage, and lower measures of pregnancy preparedness. Overweight/obesity were also prevalent in the T1DM cohort (46 % affected). The second/third trimester mean HbA1c measurements were significantly higher in the T1DM cohort. Pre-eclampsia and preterm delivery rates were similar between the cohorts. Significantly lower rates of LGA infants, NICU admission, neonatal hypoglycaemia, and neonatal respiratory distress were seen in the YT2DM cohort (p < 0.05 for all). Conclusions: In pregnancy, YT2DM appears to be the lower-risk cohort compared to T1DM despite higher obesity rates. Gaps in achieving glycaemic targets exist for both subtypes but particularly for T1DM. The relative impact of increasing BMI in pregnancies affected by T1DM requires further elucidation.
AB - Aims: Pregnancies are increasingly affected by young-onset type 2 diabetes mellitus (YT2DM), an aggressive phenotype associated with a higher vascular risk profile compared to type 1 diabetes mellitus (T1DM). We compared pregnancy outcomes to illuminate areas where differing management guidance might be needed. Methods: This retrospective single-centre study (2010 2019) included 259 singleton pregnancies affected by pregestational T1DM (N = 124) or YT2DM (N = 135) diagnosed at < 40 years. Primary outcomes included preterm delivery, large for gestational age (LGA) infants, and pre-eclampsia. Results: The YT2DM cohort were older, with more obesity, greater apparent sociodemographic disadvantage, and lower measures of pregnancy preparedness. Overweight/obesity were also prevalent in the T1DM cohort (46 % affected). The second/third trimester mean HbA1c measurements were significantly higher in the T1DM cohort. Pre-eclampsia and preterm delivery rates were similar between the cohorts. Significantly lower rates of LGA infants, NICU admission, neonatal hypoglycaemia, and neonatal respiratory distress were seen in the YT2DM cohort (p < 0.05 for all). Conclusions: In pregnancy, YT2DM appears to be the lower-risk cohort compared to T1DM despite higher obesity rates. Gaps in achieving glycaemic targets exist for both subtypes but particularly for T1DM. The relative impact of increasing BMI in pregnancies affected by T1DM requires further elucidation.
KW - Pregnancy
KW - Type 1 diabetes
KW - Type 2 diabetes
KW - Young-onset
UR - http://www.scopus.com/inward/record.url?scp=85203644302&partnerID=8YFLogxK
U2 - 10.1016/j.diabres.2024.111848
DO - 10.1016/j.diabres.2024.111848
M3 - Article
C2 - 39243867
AN - SCOPUS:85203644302
SN - 0168-8227
VL - 217
JO - Diabetes Research and Clinical Practice
JF - Diabetes Research and Clinical Practice
M1 - 111848
ER -
