Family history of T2DM – an important risk factor for "gestational diabetes" 2022EASD

Introduction: From September 19 to 23, 2022, the 2022 European Association for the Study of Diabetes Annual Conference, a major international conference in the field of endocrinology, was held
in Stockholm, Sweden in the form of "online + offline".
At the meeting, scholars shared a study entitled
"The prevalence of gestational diabetes in women with a family history of type 2 diabetes in first- and second-degree relatives".

Family history of T2DM in first- and second-degree relatives is associated with risk of GDM

A family history of type 2 diabetes mellitus (T2DM) significantly increases an individual's lifetime risk
of developing the disease.
For gestational diabetes mellitus (GDM), the characteristics of this risk factor are less well defined but may play an important role
.
To investigate the relationship between family history of T2DM and diagnosis of GDM in women with and without a family history of T2DM, and to assess differences in metabolic characteristics in the first trimester of women with and without a family history of T2DM
.

This prospective cohort study included 1164 pregnant women
.
Extensive risk assessment is performed before 16+0 weeks' gestation, including assessment of maternal characteristics, detailed family history of different types of diabetes, and laboratory tests
for glucose metabolism.
First-degree relatives are defined as parents or siblings of pregnant women, and second-degree relatives are defined as grandparents, aunts and uncles
.
Participants were followed up until delivery and GDM assessed
according to the latest diagnostic criteria of the World Health Organization.
Statistical analysis of continuous variables is summarized
by mean ± standard deviation or median, and IQR (in the case of skewed distribution).
These are compared
by ANOVA or rank-based inference.
Categorical variables are summarized by counts and percentages and compared
by binomial logistic regression.
In addition, odds ratios and 95% confidence intervals (95% CI) were calculated
for binary outcomes.
The Tukey Honesty Significant Difference (HSD) test was used for all subgroup (k=4) comparisons to achieve 95% coverage
.
Statistical analysis
using R (version 4.
0.
2) and contribution packages (especially "multcomP" and "nParcomP").
A bilateral P-value ≤ 0.
05 is considered statistically significant
.

Family history of T2DM is an important risk factor for GDM

The study found:

➤ First-degree relatives (FHD1) (n=51, 26.
6% (OR1.
91, 95% CI 1.
16-3.
16, P=0.
005), second-degree relatives (FHD2) (n=57, 26.
3% (OR1.
88, 95% CI 1.
16-3.
05, P=0.
005) or first- and second-degree relatives (FHD1+D2) had T2DM (n=31, 33.
3% (OR2.
64, 95% CI 1.
41-4.
94, P).
<0.
001) The risk of GDM was significantly increased
compared with pregnant women with a negative family history (FHN) (n=100, 15.
9%).

➤ This association was strongest if both parents had a family history of diabetes (OR4.
69, 95% CI 1.
33-16.
55, P=0.
009).

➤ Compared with women with FHN, women with FHD1 and FHD1+D2 had poor indicators of glucose metabolism, except for HDL-cholesterol
.

➤ In addition, in the first trimester, women with FHD1 and FHD1+D2 already experience impaired insulin action and higher blood glucose levels
at the time of the diagnostic OGTT test compared to women with FHN.

Summary of this article

The study confirms that family history of T2DM is an important risk factor
for GDM when current diagnostic criteria are applied.
In addition, we have demonstrated that kinship closeness plays an important role
in quantifying risk.
Future research should develop more available tools to predict GDM and include kinship closeness
when risk stratification considers family history of T2DM.

Translator's introduction

Deng Yujie

He graduated from Ruijin Hospital affiliated to Shanghai Jiao Tong University and has been engaged in basic and clinical work
related to endocrine and metabolic diseases.
He has presided over the National Natural Science Foundation of China Youth Project, Shandong Provincial Natural Science Foundation Youth Project, Qingdao Postdoctoral Application Research Project, and Shandong Geriatric Association Science and Technology Public Program Project, published more than 10 SCI articles as corresponding author, first author and co-first author, and applied for 1 international invention patent and 1 national invention patent (all first).

He specializes in the diagnosis and treatment
of diabetes, obesity, osteoporosis, adrenal glands, thyroid and other related diseases.