Association between maternal pre-existing or gestational diabetes and health problems in children

Maternal diabetes and risk of childhood cancer in the offspring

An association between maternal diabetes, its medication and childhood cancer has not been previously explored in a registry-based setting. With a case-control design, we aimed to explore whether maternal diabetes is associated with an increased risk of childhood cancer in the offspring. Combining data from population-based registries, we analyzed a total of 2,029 cases, that is, persons with childhood cancer diagnosed under the age of 20 years between years 1996-2014 and a total of 10,103 matched population controls. The mothers of the cases/controls and their diagnoses of diabetes (DM) before/during pregnancy as well as their insulin/metformin prescriptions during pregnancy were identified. Conditional logistic regression modeling was used to analyze the risk of childhood cancer. The OR for childhood cancer among those exposed to any maternal diabetes was 1.32 (95% CI 1.14-1.54) compared to the offspring of the nondiabetic mothers. The effect of maternal diabetes on the risk of childhood cancer remained elevated even after adjusting for maternal age, parity and smoking. Our data suggest that maternal diabetes medication may reduce the risk for childhood cancer (adjusted OR 0.83, 95% CI 0.36-1.94), especially in gestational diabetes (adjusted OR 0.26, 95% CI 0.05-1.25), compared to the diabetic mothers without medication. The risk of childhood leukemia was significantly higher among children exposed to any maternal diabetes (OR 1.36, CI 1.04-1.77) compared to the unexposed. Maternal diabetes appears to be associated with an increased risk of childhood cancer in the offspring. The possible risk-reducing effect of an exposure to diabetes medication on offspring cancer risk warrants further investigation.

Health-e mums: Evaluating a smartphone app design for diabetes prevention in women with previous gestational diabetes

AIM

Women with prior gestational diabetes have increased risk for developing type 2 diabetes postpartum. While diabetes prevention programs are effective in reducing a woman's risk, the reach of traditional face-to-face programs is poor in this population and using a mHealth approach appears to be promising. We aimed to evaluate a pilot smartphone app developed from an evidence-based diabetes prevention program specifically for women with previous gestational diabetes mellitus using a series of focus groups to explore the app functionality and messaging.

METHODS

The Health-e Mums app underwent an iterative, three-phase development: initial development, wireframe development and pilot testing. Twenty-six women participated in four focus groups during the pilot-testing phase. The focus group transcripts were analysed thematically to evaluate the app functionality and user-experience.

RESULTS

Focus group participants identified diabetes screening confusion and a need for personalisation as sub-themes within the app functionality theme. The user-experience exploration found generally positive findings but participants had mixed responses to the utility of video segments and applying milestones relating to diabetes prevention guidelines.

CONCLUSIONS

A user-centred approach was taken to develop a diabetes prevention program app for women with prior gestational diabetes. Women were predominantly satisfied with the overall app design, how it functioned and what the user experience would be like when fully developed.