Impact of youth onset type 2 diabetes during pregnancy on microvascular and cardiac outcomes
Document Type
Journal Article
Publication Date
8-16-2023
Journal
Diabetes research and clinical practice
Volume
203
DOI
10.1016/j.diabres.2023.110876
Keywords
Cardiovascular; Microvascular; Pregnancy; Youth-Onset Type 2 Diabetes
Abstract
AIMS: To examine the impact of pregnancy on microvascular and cardiovascular measures in women with youth-onset T2D. METHODS: Microvascular and cardiovascular measures were compared in in a cohort of 116 women who experienced a pregnancy of ≥ 20 weeks gestation and 291 women who did not among women in the Treatment Options for Type 2 Diabetes in Adolescents and Youth (TODAY) study. RESULTS: Cox regression models adjusted for participant characteristics at baseline including age, race/ethnicity, household income, diabetes duration, HbA1c (>6%), and BMI, demonstrated those who experienced pregnancy had 2.76 (1.38-5.49; p = 0.004) fold increased risk of hyperfiltration (eGFR ≥ 135 ml/min/1.73 m), compared to those without a pregnancy. No differences were observed in rates of retinopathy (48.9% vs. 41.1%) or neuropathy (23.3% vs. 16.3%) in women who experienced pregnancy vs. women who did not, respectively. In fully adjusted models, pregnancy did not impact changes in echocardiographic or arterial stiffness compared to changes in women who were never pregnant. CONCLUSIONS: These results indicate that pregnancy increases the risk of hyperfiltration in women with youth-onset T2D, but not other micro or macrovascular complications. The rates of vascular complications are very high in youth-onset T2D potentially obscuring micro- and macrovascular changes attributable to pregnancy. CLINICAL TRIAL INFORMATION: ClinicalTrials.gov numbers,NCT01364350andNCT02310724.
APA Citation
Tryggestad, Jeanie B.; Drews, Kimberly L.; Mele, Lisa; Arslanian, Silva; Chernausek, Steven D.; Escaname, Elia N.; Geffner, Mitchell; Isganaitis, Elvira; Sprague, Jennifer; and Kelsey, Megan M., "Impact of youth onset type 2 diabetes during pregnancy on microvascular and cardiac outcomes" (2023). GW Authored Works. Paper 3241.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/3241
Department
Biostatistics and Bioinformatics