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Clinical Trial
. 2023 Sep:203:110876.
doi: 10.1016/j.diabres.2023.110876. Epub 2023 Aug 16.

Impact of youth onset type 2 diabetes during pregnancy on microvascular and cardiac outcomes

Jeanie B Tryggestad  1 , Kimberly L Drews  2 , Lisa Mele  2 , Silva Arslanian  3 , Steven D Chernausek  1 , Elia N Escaname  4 , Mitchell Geffner  5 , Elvira Isganaitis  6 , Jennifer Sprague  7 , Megan M Kelsey  8 ; TODAY Study Group
Affiliations
Clinical Trial

Impact of youth onset type 2 diabetes during pregnancy on microvascular and cardiac outcomes

Jeanie B Tryggestad et al. Diabetes Res Clin Pract. 2023 Sep.

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 m2), 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.

Keywords: Cardiovascular; Microvascular; Pregnancy; Youth-Onset Type 2 Diabetes.

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Conflict of interest statement

Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Silva Arslanian receives research funding from NovoNordisk and Eli Lily consulting fees from Societe des Produits Nestle SA, honoraria for lectures from Sanofi, and participation on a data safety monitoring board or advisory board from NovoNordisk, Eli Lily, and AstraZeneca. Mitchell Geffner receives or, over the past three years, has received research funding from Diurnal, Neurocrine Biosciences, Novo Nordisk, and Spruce Biosciences; royalties from UpToDate and McGraw Hill; consulting fees from Adrenas Therapeutics, Eton Pharmaceuticals, Gilead Sciences, Neurocrine Biosciences, NovoNordisk, and Spruce Biosciences; honoraria for lectures from Pfizer and Spruce Biosciences; payment for expert testimony; support for attending meetings from Pfizer and Spruce Biosciences; and participation on a data safety monitoring board or advisory board from Ascendis Pharma, Eton Pharmaceuticals, Neurocrine Biosciences, NovoNordisk, and Pfizer. Mitchell Geffner has also had leadership roles in the Pediatric Endocrine Society, CARES Foundation, and the MAGIC Foundation. Jennifer Sprague receives research funding from Eli Lily. Megan M Kelsey receives research funding from Rhythm Pharmaceuticals, Boehringer Ingelheim, and Janssen. All other authors have nothing to report.

References

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