Pregnancy outcomes in women with young-onset type 2 diabetes: the impact of age of diabetes diagnosis and duration of diabetes

IF 3.4 3区医学 Q2 ENDOCRINOLOGY & METABOLISM

Diabetic Medicine Pub Date : 2025-05-22 DOI:10.1111/dme.70049

Xi May Zhen, Glynis Ross, Amanda Gauld, Alberto Nettel-Aguirre, Stephanie Noonan, Maria Constantino, Arianne Sweeting, Anna-Jane Harding, Adam Mackie, Hend Chatila, Margaret McGill, Timothy Middleton, Ted Wu, Stephen Twigg, Jencia Wong

{"title":"Pregnancy outcomes in women with young-onset type 2 diabetes: the impact of age of diabetes diagnosis and duration of diabetes","authors":"Xi May Zhen, Glynis Ross, Amanda Gauld, Alberto Nettel-Aguirre, Stephanie Noonan, Maria Constantino, Arianne Sweeting, Anna-Jane Harding, Adam Mackie, Hend Chatila, Margaret McGill, Timothy Middleton, Ted Wu, Stephen Twigg, Jencia Wong","doi":"10.1111/dme.70049","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Aims</h3>\n \n <p>Young-onset type 2 diabetes mellitus (YT2DM) is an aggressive phenotype, with some claiming that diagnosis at <40 years of age represents a distinct higher risk group. Others have suggested restricting YT2DM to those diagnosed at <30 years of age. In this context, we examined whether pregnancy outcomes differ between women diagnosed with YT2DM at <30 years of age (T2D30) versus those diagnosed at 30 to <40 years of age (T2D40).</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>This retrospective analysis (2010–2019) compared pregnancy outcomes in women with pre-gestational T2D30 versus T2D40. Co-primary outcomes included preterm delivery, large for gestational age (LGA) infants, and pre-eclampsia.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>Compared to T2D40 (<i>N</i> = 69), T2D30 (<i>N</i> = 66) were significantly younger, had a longer duration of diabetes, and had higher rates of smoking (<i>p</i> <0.05 for all). In both groups, obesity affected ≥60% of women and similar rates of preterm delivery and LGA infants were seen. Women with T2D30 had at least a twofold increase in the adjusted odds of excess gestational weight gain (GWG). Rates of proteinuria and pre-eclampsia were increased in T2D30, although significance was lost following adjustment for factors such as glycaemia. Younger age of YT2DM diagnosis and longer duration of YT2DM (as continuous variables), but not maternal age, were independently associated with higher mean pregnancy HbA1c and excess GWG (<i>p</i> <0.05 for both).</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>An earlier age of YT2DM diagnosis and/or longer duration of YT2DM were associated with excess GWG and a higher mean-pregnancy HbA1c. Rates of pre-eclampsia and proteinuria were increased in T2D30, likely mediated at least in part by factors such as glycaemia. Our findings suggest that the age of YT2DM diagnosis and/or duration of YT2DM, not just maternal age, should be considered when assessing pregnancy risks.</p>\n </section>\n </div>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":"42 8","pages":""},"PeriodicalIF":3.4000,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dme.70049","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Diabetic Medicine","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/dme.70049","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ENDOCRINOLOGY & METABOLISM","Score":null,"Total":0}

引用次数: 0

Abstract

Aims

Young-onset type 2 diabetes mellitus (YT2DM) is an aggressive phenotype, with some claiming that diagnosis at <40 years of age represents a distinct higher risk group. Others have suggested restricting YT2DM to those diagnosed at <30 years of age. In this context, we examined whether pregnancy outcomes differ between women diagnosed with YT2DM at <30 years of age (T2D30) versus those diagnosed at 30 to <40 years of age (T2D40).

Methods

This retrospective analysis (2010–2019) compared pregnancy outcomes in women with pre-gestational T2D30 versus T2D40. Co-primary outcomes included preterm delivery, large for gestational age (LGA) infants, and pre-eclampsia.

Results

Compared to T2D40 (N = 69), T2D30 (N = 66) were significantly younger, had a longer duration of diabetes, and had higher rates of smoking (p <0.05 for all). In both groups, obesity affected ≥60% of women and similar rates of preterm delivery and LGA infants were seen. Women with T2D30 had at least a twofold increase in the adjusted odds of excess gestational weight gain (GWG). Rates of proteinuria and pre-eclampsia were increased in T2D30, although significance was lost following adjustment for factors such as glycaemia. Younger age of YT2DM diagnosis and longer duration of YT2DM (as continuous variables), but not maternal age, were independently associated with higher mean pregnancy HbA1c and excess GWG (p <0.05 for both).

Conclusions

An earlier age of YT2DM diagnosis and/or longer duration of YT2DM were associated with excess GWG and a higher mean-pregnancy HbA1c. Rates of pre-eclampsia and proteinuria were increased in T2D30, likely mediated at least in part by factors such as glycaemia. Our findings suggest that the age of YT2DM diagnosis and/or duration of YT2DM, not just maternal age, should be considered when assessing pregnancy risks.

查看原文本刊更多论文

年轻发病的2型糖尿病妇女的妊娠结局：糖尿病诊断年龄和糖尿病病程的影响

目的：年轻发病的2型糖尿病（YT2DM）是一种侵袭性表型，一些人声称在方法上的诊断：本回顾性分析（2010-2019）比较了妊娠前T2D30和T2D40女性的妊娠结局。共同主要结局包括早产、大胎龄儿（LGA）和先兆子痫。结果：与T2D40 （N = 69）相比，T2D30 （N = 66）明显更年轻，糖尿病持续时间更长，吸烟率更高(p结论：早期诊断YT2DM和/或更长的YT2DM持续时间与过量GWG和更高的平均妊娠HbA1c相关。T2D30患者先兆子痫和蛋白尿发生率增加，可能至少部分由血糖等因素介导。我们的研究结果表明，在评估妊娠风险时，应考虑诊断为YT2DM的年龄和/或病程，而不仅仅是母亲的年龄。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Diabetic Medicine 医学-内分泌学与代谢

CiteScore

7.20

自引率

5.70%

发文量

229

审稿时长

3-6 weeks

期刊介绍： Diabetic Medicine, the official journal of Diabetes UK, is published monthly simultaneously, in print and online editions. The journal publishes a range of key information on all clinical aspects of diabetes mellitus, ranging from human genetic studies through clinical physiology and trials to diabetes epidemiology. We do not publish original animal or cell culture studies unless they are part of a study of clinical diabetes involving humans. Categories of publication include research articles, reviews, editorials, commentaries, and correspondence. All material is peer-reviewed. We aim to disseminate knowledge about diabetes research with the goal of improving the management of people with diabetes. The journal therefore seeks to provide a forum for the exchange of ideas between clinicians and researchers worldwide. Topics covered are of importance to all healthcare professionals working with people with diabetes, whether in primary care or specialist services. Surplus generated from the sale of Diabetic Medicine is used by Diabetes UK to know diabetes better and fight diabetes more effectively on behalf of all people affected by and at risk of diabetes as well as their families and carers.”