Pub Date : 2024-09-06DOI: 10.1007/s00125-024-06270-w
Diana C Soria-Contreras, Siwen Wang, Jiaxuan Liu, Rebecca B Lawn, Makiko Mitsunami, Alexandra C Purdue-Smithe, Cuilin Zhang, Emily Oken, Jorge E Chavarro
Aims/hypothesis: We aimed to determine whether a history of gestational diabetes mellitus (GDM) is associated with cognitive function in midlife.
Methods: We conducted a secondary data analysis of the prospective Nurses' Health Study II. From 1989 to 2001, and then in 2009, participants reported their history of GDM. A subset participated in a cognition sub-study in 2014-2019 (wave 1) or 2018-2022 (wave 2). We included 15,906 parous participants (≥1 birth at ≥18 years) who completed a cognitive assessment and were free of CVD, cancer and diabetes before their first birth. The primary exposure was a history of GDM. Additionally, we studied exposure to GDM and subsequent type 2 diabetes mellitus (neither GDM nor type 2 diabetes, GDM only, type 2 diabetes only or GDM followed by type 2 diabetes) and conducted mediation analysis by type 2 diabetes. The outcomes were composite z scores measuring psychomotor speed/attention, learning/working memory and global cognition obtained with the Cogstate brief battery. Mean differences (β and 95% CI) in cognitive function by GDM were estimated using linear regression.
Results: The 15,906 participants were a mean of 62.0 years (SD 4.9) at cognitive assessment, and 4.7% (n=749) had a history of GDM. In models adjusted for age at cognitive assessment, race and ethnicity, education, wave of enrolment in the cognition sub-study, socioeconomic status and pre-pregnancy characteristics, women with a history of GDM had lower performance in psychomotor speed/attention (β -0.08; 95% CI -0.14, -0.01) and global cognition (β -0.06; 95% CI -0.11, -0.01) than those without a history of GDM. The lower cognitive performance in women with GDM was only partially explained by the development of type 2 diabetes.
Conclusions/interpretation: Women with a history of GDM had poorer cognition than those without GDM. If replicated, our findings support future research on early risk modification strategies for women with a history of GDM as a potential avenue to decrease their risk of cognitive impairment.
{"title":"Lifetime history of gestational diabetes and cognitive function in parous women in midlife.","authors":"Diana C Soria-Contreras, Siwen Wang, Jiaxuan Liu, Rebecca B Lawn, Makiko Mitsunami, Alexandra C Purdue-Smithe, Cuilin Zhang, Emily Oken, Jorge E Chavarro","doi":"10.1007/s00125-024-06270-w","DOIUrl":"https://doi.org/10.1007/s00125-024-06270-w","url":null,"abstract":"<p><strong>Aims/hypothesis: </strong>We aimed to determine whether a history of gestational diabetes mellitus (GDM) is associated with cognitive function in midlife.</p><p><strong>Methods: </strong>We conducted a secondary data analysis of the prospective Nurses' Health Study II. From 1989 to 2001, and then in 2009, participants reported their history of GDM. A subset participated in a cognition sub-study in 2014-2019 (wave 1) or 2018-2022 (wave 2). We included 15,906 parous participants (≥1 birth at ≥18 years) who completed a cognitive assessment and were free of CVD, cancer and diabetes before their first birth. The primary exposure was a history of GDM. Additionally, we studied exposure to GDM and subsequent type 2 diabetes mellitus (neither GDM nor type 2 diabetes, GDM only, type 2 diabetes only or GDM followed by type 2 diabetes) and conducted mediation analysis by type 2 diabetes. The outcomes were composite z scores measuring psychomotor speed/attention, learning/working memory and global cognition obtained with the Cogstate brief battery. Mean differences (β and 95% CI) in cognitive function by GDM were estimated using linear regression.</p><p><strong>Results: </strong>The 15,906 participants were a mean of 62.0 years (SD 4.9) at cognitive assessment, and 4.7% (n=749) had a history of GDM. In models adjusted for age at cognitive assessment, race and ethnicity, education, wave of enrolment in the cognition sub-study, socioeconomic status and pre-pregnancy characteristics, women with a history of GDM had lower performance in psychomotor speed/attention (β -0.08; 95% CI -0.14, -0.01) and global cognition (β -0.06; 95% CI -0.11, -0.01) than those without a history of GDM. The lower cognitive performance in women with GDM was only partially explained by the development of type 2 diabetes.</p><p><strong>Conclusions/interpretation: </strong>Women with a history of GDM had poorer cognition than those without GDM. If replicated, our findings support future research on early risk modification strategies for women with a history of GDM as a potential avenue to decrease their risk of cognitive impairment.</p>","PeriodicalId":11164,"journal":{"name":"Diabetologia","volume":null,"pages":null},"PeriodicalIF":8.4,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142139587","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-05DOI: 10.1007/s00125-024-06268-4
Roy Taylor
{"title":"Similar early metabolic changes induced by dietary weight loss or bariatric surgery.","authors":"Roy Taylor","doi":"10.1007/s00125-024-06268-4","DOIUrl":"https://doi.org/10.1007/s00125-024-06268-4","url":null,"abstract":"","PeriodicalId":11164,"journal":{"name":"Diabetologia","volume":null,"pages":null},"PeriodicalIF":8.4,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142132118","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-05DOI: 10.1007/s00125-024-06276-4
Jan W Eriksson, Maria J Pereira, Giovanni Fanni, Ulf Risérus, Mark Lubberink, Håkan Ahlström
{"title":"Similar early metabolic changes induced by dietary weight loss or bariatric surgery. Reply to Taylor R [letter].","authors":"Jan W Eriksson, Maria J Pereira, Giovanni Fanni, Ulf Risérus, Mark Lubberink, Håkan Ahlström","doi":"10.1007/s00125-024-06276-4","DOIUrl":"https://doi.org/10.1007/s00125-024-06276-4","url":null,"abstract":"","PeriodicalId":11164,"journal":{"name":"Diabetologia","volume":null,"pages":null},"PeriodicalIF":8.4,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142132119","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-05DOI: 10.1007/s00125-024-06269-3
Decio L Eizirik, Priscila L Zimath, Xiaoyan Yi, Arturo Roca Rivada, Sarah J Richardson
{"title":"Comment on the role of interferons in the pathology of beta cell destruction in type 1 diabetes. Reply to Lenzen S [letter].","authors":"Decio L Eizirik, Priscila L Zimath, Xiaoyan Yi, Arturo Roca Rivada, Sarah J Richardson","doi":"10.1007/s00125-024-06269-3","DOIUrl":"https://doi.org/10.1007/s00125-024-06269-3","url":null,"abstract":"","PeriodicalId":11164,"journal":{"name":"Diabetologia","volume":null,"pages":null},"PeriodicalIF":8.4,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142132117","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-04DOI: 10.1007/s00125-024-06266-6
Moshe Phillip, Peter Achenbach, Ananta Addala, Anastasia Albanese-O'Neill, Tadej Battelino, Kirstine J Bell, Rachel E J Besser, Ezio Bonifacio, Helen M Colhoun, Jennifer J Couper, Maria E Craig, Thomas Danne, Carine de Beaufort, Klemen Dovc, Kimberly A Driscoll, Sanjoy Dutta, Osagie Ebekozien, Helena Elding Larsson, Daniel J Feiten, Brigitte I Frohnert, Robert A Gabbay, Mary P Gallagher, Carla J Greenbaum, Kurt J Griffin, William Hagopian, Michael J Haller, Christel Hendrieckx, Emile Hendriks, Richard I G Holt, Lucille Hughes, Heba M Ismail, Laura M Jacobsen, Suzanne B Johnson, Leslie E Kolb, Olga Kordonouri, Karin Lange, Robert W Lash, Åke Lernmark, Ingrid Libman, Markus Lundgren, David M Maahs, M Loredana Marcovecchio, Chantal Mathieu, Kellee M Miller, Holly K O'Donnell, Tal Oron, Shivajirao P Patil, Rodica Pop-Busui, Marian J Rewers, Stephen S Rich, Desmond A Schatz, Rifka Schulman-Rosenbaum, Kimber M Simmons, Emily K Sims, Jay S Skyler, Laura B Smith, Cate Speake, Andrea K Steck, Nicholas P B Thomas, Ksenia N Tonyushkina, Riitta Veijola, John M Wentworth, Diane K Wherrett, Jamie R Wood, Anette-Gabriele Ziegler, Linda A DiMeglio
{"title":"Correction to: Consensus guidance for monitoring individuals with islet autoantibody‑positive pre‑stage 3 type 1 diabetes.","authors":"Moshe Phillip, Peter Achenbach, Ananta Addala, Anastasia Albanese-O'Neill, Tadej Battelino, Kirstine J Bell, Rachel E J Besser, Ezio Bonifacio, Helen M Colhoun, Jennifer J Couper, Maria E Craig, Thomas Danne, Carine de Beaufort, Klemen Dovc, Kimberly A Driscoll, Sanjoy Dutta, Osagie Ebekozien, Helena Elding Larsson, Daniel J Feiten, Brigitte I Frohnert, Robert A Gabbay, Mary P Gallagher, Carla J Greenbaum, Kurt J Griffin, William Hagopian, Michael J Haller, Christel Hendrieckx, Emile Hendriks, Richard I G Holt, Lucille Hughes, Heba M Ismail, Laura M Jacobsen, Suzanne B Johnson, Leslie E Kolb, Olga Kordonouri, Karin Lange, Robert W Lash, Åke Lernmark, Ingrid Libman, Markus Lundgren, David M Maahs, M Loredana Marcovecchio, Chantal Mathieu, Kellee M Miller, Holly K O'Donnell, Tal Oron, Shivajirao P Patil, Rodica Pop-Busui, Marian J Rewers, Stephen S Rich, Desmond A Schatz, Rifka Schulman-Rosenbaum, Kimber M Simmons, Emily K Sims, Jay S Skyler, Laura B Smith, Cate Speake, Andrea K Steck, Nicholas P B Thomas, Ksenia N Tonyushkina, Riitta Veijola, John M Wentworth, Diane K Wherrett, Jamie R Wood, Anette-Gabriele Ziegler, Linda A DiMeglio","doi":"10.1007/s00125-024-06266-6","DOIUrl":"https://doi.org/10.1007/s00125-024-06266-6","url":null,"abstract":"","PeriodicalId":11164,"journal":{"name":"Diabetologia","volume":null,"pages":null},"PeriodicalIF":8.4,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142125124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-02DOI: 10.1007/s00125-024-06259-5
Rebecca L Thomson, James D Brown, Helena Oakey, Kirsten Palmer, Pat Ashwood, Megan A S Penno, Kelly J McGorm, Rachel Battersby, Peter G Colman, Maria E Craig, Elizabeth A Davis, Tony Huynh, Leonard C Harrison, Aveni Haynes, Richard O Sinnott, Peter J Vuillermin, John M Wentworth, Georgia Soldatos, Jennifer J Couper
Aims/hypothesis: Dietary patterns characterised by high intakes of vegetables may lower the risk of pre-eclampsia and premature birth in the general population. The effect of dietary patterns in women with type 1 diabetes, who have an increased risk of complications in pregnancy, is not known. The aim of this study was to investigate the relationship between dietary patterns and physical activity during pregnancy and maternal complications and birth outcomes in women with type 1 diabetes. We also compared dietary patterns in women with and without type 1 diabetes.
Methods: Diet was assessed in the third trimester using a validated food frequency questionnaire in participants followed prospectively in the multi-centre Environmental Determinants of Islet Autoimmunity (ENDIA) study. Dietary patterns were characterised by principal component analysis. The Pregnancy Physical Activity Questionnaire was completed in each trimester. Data for maternal and birth outcomes were collected prospectively.
Results: Questionnaires were completed by 973 participants during 1124 pregnancies. Women with type 1 diabetes (n=615 pregnancies with dietary data) were more likely to have a 'fresh food' dietary pattern than women without type 1 diabetes (OR 1.19, 95% CI 1.07, 1.31; p=0.001). In women with type 1 diabetes, an increase equivalent to a change from quartile 1 to 3 in 'fresh food' dietary pattern score was associated with a lower risk of pre-eclampsia (OR 0.37, 95% CI 0.17, 0.78; p=0.01) and premature birth (OR 0.35, 95% CI 0.20, 0.62, p<0.001). These associations were mediated in part by BMI and HbA1c. The 'processed food' dietary pattern was associated with an increased birthweight (β coefficient 56.8 g, 95% CI 2.8, 110.8; p=0.04). Physical activity did not relate to outcomes.
Conclusions/interpretation: A dietary pattern higher in fresh foods during pregnancy was associated with sizeable reductions in risk of pre-eclampsia and premature birth in women with type 1 diabetes.
{"title":"Dietary patterns during pregnancy and maternal and birth outcomes in women with type 1 diabetes: the Environmental Determinants of Islet Autoimmunity (ENDIA) study.","authors":"Rebecca L Thomson, James D Brown, Helena Oakey, Kirsten Palmer, Pat Ashwood, Megan A S Penno, Kelly J McGorm, Rachel Battersby, Peter G Colman, Maria E Craig, Elizabeth A Davis, Tony Huynh, Leonard C Harrison, Aveni Haynes, Richard O Sinnott, Peter J Vuillermin, John M Wentworth, Georgia Soldatos, Jennifer J Couper","doi":"10.1007/s00125-024-06259-5","DOIUrl":"https://doi.org/10.1007/s00125-024-06259-5","url":null,"abstract":"<p><strong>Aims/hypothesis: </strong>Dietary patterns characterised by high intakes of vegetables may lower the risk of pre-eclampsia and premature birth in the general population. The effect of dietary patterns in women with type 1 diabetes, who have an increased risk of complications in pregnancy, is not known. The aim of this study was to investigate the relationship between dietary patterns and physical activity during pregnancy and maternal complications and birth outcomes in women with type 1 diabetes. We also compared dietary patterns in women with and without type 1 diabetes.</p><p><strong>Methods: </strong>Diet was assessed in the third trimester using a validated food frequency questionnaire in participants followed prospectively in the multi-centre Environmental Determinants of Islet Autoimmunity (ENDIA) study. Dietary patterns were characterised by principal component analysis. The Pregnancy Physical Activity Questionnaire was completed in each trimester. Data for maternal and birth outcomes were collected prospectively.</p><p><strong>Results: </strong>Questionnaires were completed by 973 participants during 1124 pregnancies. Women with type 1 diabetes (n=615 pregnancies with dietary data) were more likely to have a 'fresh food' dietary pattern than women without type 1 diabetes (OR 1.19, 95% CI 1.07, 1.31; p=0.001). In women with type 1 diabetes, an increase equivalent to a change from quartile 1 to 3 in 'fresh food' dietary pattern score was associated with a lower risk of pre-eclampsia (OR 0.37, 95% CI 0.17, 0.78; p=0.01) and premature birth (OR 0.35, 95% CI 0.20, 0.62, p<0.001). These associations were mediated in part by BMI and HbA<sub>1c</sub>. The 'processed food' dietary pattern was associated with an increased birthweight (β coefficient 56.8 g, 95% CI 2.8, 110.8; p=0.04). Physical activity did not relate to outcomes.</p><p><strong>Conclusions/interpretation: </strong>A dietary pattern higher in fresh foods during pregnancy was associated with sizeable reductions in risk of pre-eclampsia and premature birth in women with type 1 diabetes.</p>","PeriodicalId":11164,"journal":{"name":"Diabetologia","volume":null,"pages":null},"PeriodicalIF":8.4,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142105299","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-31DOI: 10.1007/s00125-024-06252-y
Fidelma Dunne, Christine Newman, Alberto Alvarez-Iglesias, Paula O’Shea, Declan Devane, Paddy Gillespie, Aoife Egan, Martin O’Donnell, Andrew Smyth
Aims/hypothesis
Gestational diabetes mellitus (GDM) is associated with adverse perinatal outcomes because of suboptimal glucose management and glucose control and excessive weight gain. Metformin can offset these factors but is associated with small for gestational age (SGA) infants. We sought to identify risk factors for SGA infants, including the effect of metformin exposure on SGA status.
Methods
In this prespecified secondary analysis of the EMERGE trial, which evaluated the effectiveness of metformin vs placebo in treating GDM and found reduced gestational weight gain and longer time to insulin initiation with metformin use, we included women with a live-born infant and known infant birthweight and gestational age at delivery. We compared the numbers of SGA infants in both groups and explored baseline predictive factors to help identify those at highest risk of delivering an SGA infant.
Results
Baseline maternal characteristics were similar between SGA and non-SGA pregnancies. On multivariable-adjusted regression, no baseline maternal variables were associated with SGA status. Mothers of SGA infants were more likely to develop pre-eclampsia or gestational hypertension (18.2% vs 2.0%, p=0.001; 22.7% vs 5.4%, p=0.005, respectively); after multivariable adjustment, pre-eclampsia was positively associated with SGA status). Among SGA pregnancies, important perinatal outcomes including preterm birth, Caesarean delivery and neonatal care unit admission did not differ between the metformin and placebo groups (20.0% vs 14.3%, p=1.00; 50.0% vs 28.6%, p=0.25; 13.3% vs 42.9%, p=0.27, respectively).
Conclusions/interpretation
Pre-eclampsia was strongly associated with SGA infants. Metformin-exposed SGA infants did not display a more severe SGA phenotype than infants treated with placebo.