Does First Nations ancestry modify the association between gestational diabetes and subsequent diabetes: a historical prospective cohort study among women in Manitoba, Canada

Abstract

word count: 249 Manuscript word count: 3,118 Bulleted novelty statement:This historical cohort study examined the impact of gestational diabetes mellitus (GDM) after excluding pre-existing diabetes in mothers who delivered from 1981-2011 in Manitoba, Canada. First Nations (FN) women had 2-times more GDM and were 3-times more likely to develop postpartum diabetes than non-FN women. Postpartum diabetes in both FN and non-FN mothers was affected by GDM, lower family income and rural residence. The relative risk of developing postpartum diabetes in non-FN women was higher than FN women. The findings suggest that the reduction of GDM and socioeconomic inequities are required for preventing postpartum diabetes in FN and non-FN women.Running title: GDM and subsequent diabetes in mothers 2 Abstract Background: Over the past 30 years, the prevalence of diabetes has steadily increased among

Intensive gestational glycemic management and childhood obesity: a systematic review and meta-analysis

“…Offspring were included if they could be linked to their mother and had a live birth date within the study inclusion period. 99,178 They were excluded from the cohort if they had ≥1 diagnosis of congenital anomaly of the cardiovascular system or of ineligible cardiomyopathy (endocardial fibroelastosis or congenital/familial cardiomyopathy), if they died during their birth hospitalisation, if they had invalid public health insurance coverage (as it is through this insurance number that they were tracked through databases), or if they developed non-type 2 diabetes during the study period (Figure 4.1). As administrative data cannot differentiate well between types of diabetes, all children with diabetes diagnosed at <7 years of age were excluded from the analysis because of the unlikelihood of their condition being type 2 diabetes.…”

“…This exposure was defined from one of four datasets: hospitalisations, physician claims, clinical pediatric endocrinology, and medication prescription data as previously described. 99,179 GDM was defined as a confirmed diagnosis of diabetes (through hospital abstract forms or physician visits) between 21 weeks of gestation and six weeks post-partum 178,186 , in the absence of a non-GDM diabetes diagnosis the previous or following year.…”

“…ICD-9-CM codes were used until 1 April 2004, and ICD-10-CA codes were used afterwards to define diabetes and GDM. These definitions of GDM and pre-existing diabetes have been used previously 178,179 . 190,191 A score of 0 represents the provincial average and 95% of the scores fall within ± 2 points, with higher values indicating higher deprivation (i.e.…”

Primary Health Care for Aboriginal Australian Women in Remote Communities after a Pregnancy with Hyperglycaemia

“…For women with GDM, there is a high risk of developing GDM in subsequent pregnancies and, later, T2D and cardiovascular disease [6]. The burden of disease is greater for Indigenous women, with higher rates of GDM and T2D in pregnancy than their non-Indigenous counterparts [7][8][9][10]. In Australia, Aboriginal and Torres Strait Islander women are 1.5 times more likely to have GDM, 10.4 times more likely to have pre-existing T2D [3], and four times more likely to develop T2D after GDM, compared with non-Indigenous women [11].…”

Type 2 diabetes after gestational diabetes: Can the progression be prevented?

“…In a 30-year follow-up study of women postpregnancy, First Nations women with prior gestational diabetes had the highest rate of diabetes, almost 80%, compared with non-First Nations women postgestational diabetes and nongestational diabetes women. 6 Although risk factors can help identify those women with gestational diabetes at highest risk of developing diabetes such as ethnicity, family history of diabetes, advanced maternal age, early diagnosis of gestational diabetes, use of insulin, and hypertensive disorders, the development of metabolic markers may greatly enhance prediction and perhaps patient motivation for prevention as personalized medicine progresses. 7 It is evident that the early post-partum period is a very challenging time for mothers to engage in lifestyle interventions.…”