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. 2019 Oct;56(10):1133-1140.
doi: 10.1007/s00592-019-01354-1. Epub 2019 May 13.

Temporal trends without seasonal effects on gestational diabetes incidence relate to reductions in indices of insulin secretion: the Cambridge Baby Growth Study

Clive J Petry  1 , Benjamin G Fisher  2 , Ken K Ong  2   3   4 , Ieuan A Hughes  2 , Carlo L Acerini  2 , David B Dunger  2   4
Affiliations

Temporal trends without seasonal effects on gestational diabetes incidence relate to reductions in indices of insulin secretion: the Cambridge Baby Growth Study

Clive J Petry et al. Acta Diabetol. 2019 Oct.

Abstract

Aims: The incidence of gestational diabetes has been reported to have risen over the first decade of this century. Some studies have also found it to vary with seasons of the year. We investigated temporal and seasonal trends on gestational diabetes incidence in a single-centre cohort study from Cambridge, UK, and attempted to explain trends using associated risk factors.

Methods: Using a cosinor model, we tested both temporal and seasonal trends in gestational diabetes incidence in 1074 women recruited to the Cambridge Baby Growth Study in 2001-2009 who underwent oral glucose tolerance tests around week 28 of pregnancy.

Results: There was a temporal increase in gestational diabetes incidence over the course of recruitment to this study [0.014 (0.005, 0.022) proportional increase per year, p = 2.1 × 10-3], but no seasonal effect (p = 0.7). HOMA B [- 0.015 (- 0.025, - 0.005) per year, p = 3.0 × 10-3] and the insulin disposition index [- 0.036 (- 0.060, - 0.013) per year, p = 3.0 × 10-3], unlike HOMA S, showed negative temporal trends. Risk factor analyses showed a concomitant temporal slight increase in the index of multiple deprivation [0.191 (0.138, 0.257) units per year, p = 4.6 × 10-10]. This index was positively associated with HOMA B (p = 6.1 × 10-5) but not directly with gestational diabetes (p = 0.6), HOMA S (p = 0.2) or the insulin disposition index (p = 0.4).

Conclusions: In this cohort, there were temporal, but not seasonal, increases in gestational diabetes incidence between the years 2001 and 2009, which appeared to be related more to reductions in insulin secretion than sensitivity. Possible mediators of this link include confounding factors related to deprivation.

Keywords: Cosinor; Deprivation; Insulin sensitivity; Pregnancy.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
a Proportion of women with GDM by the season of the year, following an OGTT around week 28 of pregnancy, adjusted for year of analysis. Data are means (95% confidence intervals). Analysing this data categorically (taking no account of the recurring order of the seasons) showed no association between GDM and season of the year (χ2 = 2.2, p = 0.5). b Proportion of women with GDM by the year of testing, following an OGTT around week 28 of pregnancy
Fig. 2
Fig. 2
Dot plot of OGTT 60-min glucose concentrations by the year of OGTT testing. The bars represent the limits of the inter-quartile range of the values represented by the dots
Fig. 3
Fig. 3
Dot plots of a the index of multiple deprivation by year of testing and b HOMA B values by the index of multiple deprivation. The lines of best fit (minimising the distance between the line and median values) were calculated using the Siegel repeated medians procedure
See this image and copyright information in PMC

References

    1. American Diabetes Association Diagnosis and classification of diabetes mellitus. Diabetes Care. 2010;33(Supplement 1):S62–S69. doi: 10.2337/dc10-S062. - DOI - PMC - PubMed
    1. American Diabetes Association Classification and diagnosis of diabetes: standards of medical care in diabetes—2018. Diabetes Care. 2018;41(Supplement 1):S13–S27. doi: 10.2337/dc18-S002. - DOI - PubMed
    1. Chu SY, Callaghan WM, Kim SY, et al. Maternal obesity and risk of gestational diabetes mellitus. Diabetes Care. 2007;30:2070–2076. doi: 10.2337/dc06-2559a. - DOI - PubMed
    1. Petry CJ. Gestational diabetes: risk factors and recent advances in its genetics and treatment. Br J Nutr. 2010;104:775–787. doi: 10.1017/S0007114510001741. - DOI - PubMed
    1. Salzer L, Yogev Y. Complications of gestational diabetes. In: Petry CJ, editor. Gestational diabetes: origins, complications and treatment. Boca Raton: CRC Press; 2014. pp. 95–115.

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