The effect of paternal and maternal history of diabetes mellitus on the development of gestational diabetes mellitus

Urinary tract infection in patients with diabetes mellitus and the role of parental genetics in the emergence of the disease

This study aimed to assess the role of paternal genetics in the development of diabetic mellitus (DM) and determine the impact of DM on the urinary system by investigating the percentage of patients with urinary tract infection (UTI). The study included 100 people with DM; their ages ranged from 5 to 83 years. The DM and blood sugar levels were diagnosed clinically and at a laboratory in Al-Zahra Teaching Hospital and the outpatient clinics. The age, gender, and causes of DM and the family history of diabetes were reported. Isolation and identification of bacterial species were made depending on culture media and biochemical tests. The average age of patients was 47.7±5.5, and most of them were female (67%). The incidence of DM increased with age, and the main cause of DM was likely to be a genetic predisposition (family history), where 32% of patients appeared to have a positive family history and the presence of DM in both parents or only the mother had a significant role in increasing the genetic predisposition of developing DM. Among the non-genetic causes of DM, the most common was exposure to sudden psychological or nervous shock (41%). Obesity also had an important role in the development of diabetes, and also pregnancy and smoking. Moreover, 66% of patients with type 2 DM and all with type 1 DM suffered from UTIs. The main causative agents were E. coli (60%) and Proteus spp. (13%). The majority of patients suffering from UTIs (73%) were females. In conclusion, type 2 DM is the most common, especially in females, and increases with age. The main cause of DM was family genetic predisposition and sudden shocks. The current study also showed that most diabetic patients suffered from UTIs, especially females, and the main causes of UTI inflammation are E. coli isolates.

Gestational Diabetes Mellitus (GDM) Risk for Declared Family History of Diabetes, in Combination with BMI Categories

Whether categories of family history of diabetes can act as independent risk factors for gestational diabetes mellitus (GDM-1, -2) has not yet been established, and neither has it been established how categories of body mass index (BMI) affect these relationships. A group of 912 women without chronic diseases, recruited in the first trimester, was investigated: 125 (13.7%) women developed GDM-1 (treated with diet); 21 (2.3%) women developed GDM-2 (treated with insulin); and a control group consisted of 766 non-diabetic women. A multiple logistic regression was used to evaluate adjusted odds ratios (AOR (95% confidence intervals)) of GDM-1 and GDM-2 for declared diabetes in the parents or grandparents (separately). These relationships were investigated in the whole cohort and subgroups of pre-pregnancy BMI. (1) Some categories of the family history were independent risk factors of GDM-1 or GDM-2. Compared to ‘absence of diabetes in the family’, women with diabetes in the father had a 3.68-fold increase in GDM-1 risk (AOR-b = 3.68 (2.23–6.07)), and women with diabetes in the mother had a 2.13-fold increase in GDM-1 risk (AOR-b = 2.13 (1.1–4.14)) and a 4.73-fold increase in GDM-2 risk (AOR-b = 4.73 (1.26–17.77)). Women with diabetes in the grandmother had a 2.34-fold increase in GDM-1 risk (AOR-b = 2.34 (1.29–4.24)). (2) The cumulative assessment of diabetes in the parents and/or grandparents was not related to the intensification of the risk of GDM, except for the increased risk of GDM-1 for diabetes in both mother and grandmothers simultaneously (AOR-b = 8.80 (1.16–66.57)), however, this group was very small. (3) The analyses in the subgroups of BMI categories showed that diabetes in the father was also an independent risk factor of GDM in the subgroup of pregnant women with normal BMI. In the subgroups of overweight and/or obesity, the risk of GDM for paternal and maternal diabetes was approximately twice as high as compared to the results of pregnant women with normal BMIs. Additionally, apart from the maternal influence of diabetes, the results suggest a significant influence of diabetes in the father on the risk of GDM, even (interestingly) in lean pregnant women.

Maternal and paternal histories differentially influence risks for diabetes, insulin secretion and insulin resistance in a Chinese population

Aims/Introduction

To investigate the differential effects of maternal versus paternal history of diabetes on the risks for diabetes and prediabetes, as well as on insulin secretion and resistance in Chinese individuals.

Materials and Methods

From the 2007 to 2008 China National Diabetes and Metabolism Disorders Study, 39,244 participants were included and divided into four categories: negative parental history, paternal history only (PH), maternal history only (MH), and both paternal and maternal history.

Results

The age‐ and sex‐standardized prevalence rates of diabetes in the negative parental history, PH, MH, and both paternal and maternal history groups were 8.59, 12.56, 15.86 and 29.81%, respectively. The prevalence rates of impaired glucose metabolism were 24.13, 25.41, 31.13 and 50.80%, with the prevalence in the MH group being significantly higher than that in the PH group. Compared with that in the FH0 group, the risks of diabetes in the PH, MH, and both paternal and maternal history groups were 2.01‐, 2.67‐ and 6.37‐fold greater, and the risks of impaired glucose metabolism were 1.28‐, 1.65‐ and 3.45‐fold greater. In addition, MH had a significantly greater impact on impaired glucose metabolism than PH (P_MHvsPH = 0.0292). Regression analyses suggested MH was associated with homeostatic model assessment for β‐cell function (β[SE] = −0.0910[0.0334], P = 0.0065), insulinogenic index (−0.1866[0.0550], P = 0.0007), homeostatic model assessment for insulin resistance (0.0662[0.0227], P = 0.0036) and Matsuda Index [−0.0716(0.0203), P = 0.0004]. PH was specifically associated with homeostatic model assessment for insulin resistance (0.1343[0.0267], P < 0.0001) and Matsuda Index (−0.1566[0.0243], P < 0.0001), but the effects were stronger than those of MH (P_MHvsPH = 0.0431, 0.0054).

Conclusions

MH and PH differentially influence the risks for diabetes, insulin secretion, and insulin resistance in the Chinese population, suggesting they participate in the pathogenesis of diabetes through different mechanisms.

High Prevalence of Gestational Diabetes Mellitus in Beijing: Effect of Maternal Birth Weight and Other Risk Factors

BACKGROUND

Gestational diabetes mellitus (GDM) is associated with both short- and long-term adverse health consequences for both the mother and her offspring. The aim was to study the prevalence and risk factors for GDM in Beijing.

METHODS

The study population consisted of 15,194 pregnant women attending prenatal care in 15 hospitals in Beijing, who delivered between June 20, 2013, and November 30, 2013, after 28 weeks of gestation. The participants were selected by cluster sampling from the 15 hospitals identified through random systematic sampling based on the number of deliveries in 2012. A questionnaire was designed to collect information.

RESULTS

A total of 2987 (19.7%) women were diagnosed with GDM and 208 (1.4%) had diabetes in pregnancy (DIP). Age (OR: 1.053, 95% CI: 1.033-1.074, P < 0.01), family history of diabetes mellitus (OR: 1.481, 95% CI: 1.254-1.748, P < 0.01), prepregnancy body mass index (BMI) (OR: 1.481, 95% CI: 1.254-1.748, P < 0.01), BMI gain before 24 weeks (OR: 1.126, 95% CI: 1.075-1.800, P < 0.01), maternal birth weight (P < 0.01), and fasting plasma glucose at the first prenatal visit (P < 0.01) were identified as risk factors for GDM. In women with birth weight <3000 g, GDM rate was significantly higher.

CONCLUSIONS

One out of every five pregnant women in Beijing either had GDM or DIP and this constitutes a huge health burden for health services. Prepregnancy BMI and weight gain before 24th week are important modifiable risk factors for GDM. Ensuring birth weight above 3000 g may help reduce risk for future GDM among female offsprings.

[Long term outcome in children of mothers with gestational diabetes]

OBJECTIVES

To appreciate, in epidemiological studies, the impact of fetal exposure to gestational diabetes on the long term outcome of the offspring (type 2 diabetes, overweight and obesity, metabolic syndrome and neurological complications).

METHODS

A systematic search was conducted in Medline between January 1990 and April 2010. Prospective studies (follow-up of the offspring born of mothers with gestational diabetes) and retrospective studies (questionnaire about the parents'history of diabetes in diabetic patients) were searched and analysed.

RESULTS

The fetal exposure to maternal gestational diabetes is a moderate risk factor for metabolic syndrome in the offspring. But some other perinatal risk factors of metabolic syndrome carry a bigger influence. The influence of genetic factors and maternal overweight may not be easily distinguished from the impact of fetal exposure to gestational diabetes.

CONCLUSION

It remains uncertain if the control of maternal glycemia alone may be effective and sufficient to prevent the metabolic syndrome in the adult-aged offspring.

Definition, epidemiology, risk factors

Gestational diabetes mellitus is defined as glucose intolerance that begins or is first recognized during pregnancy. Its prevalence, generally situated between 2-6%, may reach 10-20% in high-risk populations, with an increasing trend across most racial/ethnic groups studied. Among traditional risk factors, previous gestational diabetes, advanced maternal age and obesity have the highest impact on gestational diabetes risk. Racial/ethnic origin and family history of type 2 diabetes have a significant but moderate impact (except for type 2 diabetes in siblings). Several non traditional factors have been recently characterized, either physiological (low birthweight and short maternal height) or pathological (polycystic ovaries). The multiplicity of risk factors and their interactions results in a low reliability of risk prediction on an individual basis.

Maternal glycemia and risk of large-for-gestational-age babies in a population-based screening

OBJECTIVE

Gestational diabetes is a risk factor for large-for-gestational-age (LGA) newborns, but many LGA babies are born to mothers with normal glucose tolerance. We aimed to clarify the association of maternal glycemia across the whole distribution with birth weight and risk of LGA births in mothers with normal glucose tolerance.

RESEARCH DESIGN AND METHODS

We undertook a population-based gestational diabetes screening in an urban area of Hungary in 2002-2005. All singleton pregnancies of mothers >or=18 years of age, without known diabetes or gestational diabetes (World Health Organization criteria) and data on a 75-g oral glucose tolerance test at 22-30 weeks of gestation, were included (n = 3,787, 78.9% of the target population). LGA was determined as birth weight greater than the 90th percentile using national sex- and gestational age-specific charts.

RESULTS

Mean +/- SD maternal age was 30 +/- 4 years, BMI was 22.6 +/- 4.0 kg/m(2), fasting blood glucose was 4.5 +/- 0.5 mmol/l, and postload glucose was 5.5 +/- 1.0 mmol/l. The mean birth weight was 3,450 +/- 476 g at 39.2 +/- 1.2 weeks of gestation. There was a U-shaped association of maternal fasting glucose with birth weight (P(curve) = 0.004) and risk of having an LGA baby (lowest values between 4 and 4.5 mmol/l, P(curve) = 0.0004) with little change after adjustments for clinical characteristics. The association of postload glucose with birth weight (P = 0.03) and the risk of an LGA baby (P = 0.09) was weaker and linear.

CONCLUSIONS

Both low and high fasting glucose values at 22-30 weeks of gestation are associated with increased risk of an LGA newborn. We suggest that the excess risk related to low glucose reflects the increased use of nutrients by LGA fetuses that also affects the mothers' fasting glucose.