Preterm birth and risk of type 1 and type 2 diabetes: a national cohort study

Abstract Aims/hypothesis Preterm birth (gestational age <37 weeks) has been associated with insulin resistance early in life. However, no large population-based studies have examined risks of type 1 and type 2 diabetes and potential sex-specific differences from childhood into adulthood. Clinicians will increasingly encounter adults who were born prematurely and will need to understand their long-term risks. We hypothesised that preterm birth is associated with increased risks of type 1 and type 2 diabetes into adulthood. Methods A national cohort study was conducted of all 4,193,069 singletons born in Sweden during 1973–2014, who were followed up for type 1 and type 2 diabetes identified from nationwide diagnoses and pharmacy data to the end of 2015 (maximum age 43 years; median age at the end of follow-up 22.5 years). Cox regression was used to adjust for potential confounders, and co-sibling analyses assessed the influence of shared familial (genetic and/or environmental) factors. Results In 92.3 million person-years of follow-up, 27,512 (0.7%) and 5525 (0.1%) people were identified with type 1 and type 2 diabetes, respectively. Gestational age at birth was inversely associated with both type 1 and type 2 diabetes risk. Adjusted HRs for type 1 and type 2 diabetes at age <18 years associated with preterm birth were 1.21 (95% CI, 1.14, 1.28) and 1.26 (95% CI, 1.01, 1.58), respectively, and at age 18–43 years were 1.24 (95% CI, 1.13, 1.37) and 1.49 (95% CI, 1.31, 1.68), respectively, compared with full-term birth. The associations between preterm birth and type 2 (but not type 1) diabetes were stronger among females (e.g. at age 18–43 years, females: adjusted HR, 1.75; 95% CI, 1.47, 2.09; males: 1.28; 95% CI, 1.08, 1.53; p < 0.01 for additive and multiplicative interaction). These associations were only partially explained by shared genetic or environmental factors in families. Conclusions/interpretation In this large national cohort, preterm birth was associated with increased risk of type 1 and type 2 diabetes from childhood into early to mid-adulthood. Preterm-born children and adults may need early preventive evaluation and long-term monitoring for diabetes.

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Preterm birth and risk of chronic kidney disease from childhood into mid-adulthood: national cohort study

BMJ ◽

10.1136/bmj.l1346 ◽

2019 ◽

pp. l1346 ◽

Cited By ~ 48

Author(s):

Casey Crump ◽

Jan Sundquist ◽

Marilyn A Winkleby ◽

Kristina Sundquist

Keyword(s):

Cohort Study ◽

Preterm Birth ◽

Environmental Factors ◽

Gestational Age ◽

Early Term ◽

Extremely Preterm ◽

National Cohort ◽

Gestational Age At Birth ◽

Age At Birth

Abstract Objective To investigate the relation between preterm birth (gestational age <37 weeks) and risk of CKD from childhood into mid-adulthood. Design National cohort study. Setting Sweden. Participants 4 186 615 singleton live births in Sweden during 1973-2014. Exposures Gestational age at birth, identified from nationwide birth records in the Swedish birth registry. Main outcome measures CKD, identified from nationwide inpatient and outpatient diagnoses through 2015 (maximum age 43 years). Cox regression was used to examine gestational age at birth and risk of CKD while adjusting for potential confounders, and co-sibling analyses assessed the influence of unmeasured shared familial (genetic or environmental) factors. Results 4305 (0.1%) participants had a diagnosis of CKD during 87.0 million person years of follow-up. Preterm birth and extremely preterm birth (<28 weeks) were associated with nearly twofold and threefold risks of CKD, respectively, from birth into mid-adulthood (adjusted hazard ratio 1.94, 95% confidence interval 1.74 to 2.16; P<0.001; 3.01, 1.67 to 5.45; P<0.001). An increased risk was observed even among those born at early term (37-38 weeks) (1.30, 1.20 to 1.40; P<0.001). The association between preterm birth and CKD was strongest at ages 0-9 years (5.09, 4.11 to 6.31; P<0.001), then weakened but remained increased at ages 10-19 years (1.97, 1.57 to 2.49; P<0.001) and 20-43 years (1.34, 1.15 to 1.57; P<0.001). These associations affected both males and females and did not seem to be related to shared genetic or environmental factors in families. Conclusions Preterm and early term birth are strong risk factors for the development of CKD from childhood into mid-adulthood. People born prematurely need long term follow-up for monitoring and preventive actions to preserve renal function across the life course.

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Risk of hypertension into adulthood in persons born prematurely: a national cohort study

European Heart Journal ◽

10.1093/eurheartj/ehz904 ◽

2019 ◽

Vol 41 (16) ◽

pp. 1542-1550 ◽

Cited By ~ 7

Author(s):

Casey Crump ◽

Jan Sundquist ◽

Kristina Sundquist

Keyword(s):

Cohort Study ◽

Preterm Birth ◽

Environmental Factors ◽

Gestational Age ◽

Large Population ◽

Increased Risk ◽

Extremely Preterm ◽

National Cohort ◽

Gestational Age At Birth ◽

Age At Birth

Abstract Aims Preterm birth has been associated with elevated blood pressure early in life; however, hypertension risks from childhood into adulthood remain unclear. We conducted a large population-based study to examine gestational age at birth in relation to hypertension risks from childhood into adulthood. Methods and results A national cohort study was conducted of all 4 193 069 singleton live births in Sweden during 1973–2014, who were followed up for hypertension identified from nationwide inpatient and outpatient (specialty and primary care) diagnoses from any health care encounters through 2015 (maximum age 43 years; median 22.5). Cox regression was used to examine gestational age at birth in relation to hypertension risk while adjusting for other perinatal and maternal factors, and co-sibling analyses assessed the potential influence of unmeasured shared familial (genetic and/or environmental) factors. In 86.8 million person-years of follow-up, 62 424 (1.5%) persons were identified with hypertension (median age 29.8 years at diagnosis). Adjusted hazard ratios for new-onset hypertension at ages 18–29 years associated with preterm (<37 weeks) and extremely preterm (22–27 weeks) birth were 1.28 [95% confidence interval (CI), 1.21–1.36] and 2.45 (1.82–3.31), respectively, and at ages 30–43 years were 1.25 (1.18–1.31) and 1.68 (1.12–2.53), respectively, compared with full-term birth (39–41 weeks). These associations affected males and females similarly and appeared substantially related to shared genetic or environmental factors in families. Conclusions In this large national cohort, preterm birth was associated with increased risk of hypertension into early adulthood. Persons born prematurely may need early preventive evaluation and long-term monitoring for the development of hypertension.

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QTc interval and resting heart rate as long-term predictors of mortality in type 1 and type 2 diabetes mellitus: a 23-year follow-up

Diabetologia ◽

10.1007/s00125-006-0483-1 ◽

2006 ◽

Vol 50 (1) ◽

pp. 186-194 ◽

Cited By ~ 60

Author(s):

C. Stettler ◽

A. Bearth ◽

S. Allemann ◽

M. Zwahlen ◽

L. Zanchin ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Heart Rate ◽

Type 2 Diabetes Mellitus ◽

Qtc Interval ◽

Resting Heart Rate

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The early impact of the COVID-19 pandemic on adults with type 1 or type 2 diabetes: A national cohort study

Journal of Diabetes and its Complications ◽

10.1016/j.jdiacomp.2020.107748 ◽

2020 ◽

Vol 34 (12) ◽

pp. 107748 ◽

Cited By ~ 1

Author(s):

Lawrence Fisher ◽

William Polonsky ◽

Adijat Asuni ◽

Yasmin Jolly ◽

Danielle Hessler

Keyword(s):

Type 2 Diabetes ◽

Cohort Study ◽

National Cohort

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Diabetes is associated with decreased migraine risk: A nationwide cohort study

Cephalalgia ◽

10.1177/0333102417748573 ◽

2017 ◽

Vol 38 (11) ◽

pp. 1759-1764 ◽

Cited By ~ 5

Author(s):

Ippazio Cosimo Antonazzo ◽

Trond Riise ◽

Marianna Cortese ◽

Line Iden Berge ◽

Anders Engeland ◽

...

Keyword(s):

Type 2 Diabetes ◽

Type 1 Diabetes ◽

Cohort Study ◽

Educational Level ◽

Proportional Hazards ◽

Cox Proportional Hazards ◽

Prescription Database

Background Results from studies on diabetes and migraine risk are conflicting, which may be due to methodological limitations. Prospective studies with long follow-up could increase our understanding of the relationship between the two diseases. Method We performed a cohort study including the whole Norwegian population alive on 01.01.2004, using prescriptions registered in the Norwegian prescription database to identify individuals developing type 1 diabetes, type 2 diabetes and migraine during follow-up (10 years). We used Cox proportional hazards regression to estimate rate ratios with corresponding 95% confidence intervals for the effect of diabetes on migraine risk, adjusting for age, sex, and educational level. Result We identified 7,883 type 1 diabetes patients and 93,600 type 2 patients during the study period. Type 1 diabetes was significantly associated with a subsequent decreased migraine risk during follow-up in the age- and sex-adjusted analyses (0.74; 0.61–0.89). Type 2 diabetes was also associated with a significantly lower migraine risk (0.89; 0.83–0.95). Further adjustment for educational level yielded similar results for both diabetes. Conclusion Both type 1 and type 2 diabetes were significantly associated with a decreased risk of migraine. This suggests that diabetes or diabetes treatment may have a protective effect on the development of migraine.

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Increased risk of long‐term sickness absence, lower rate of return to work and higher risk of disability pension among people with type 1 and type 2 diabetes mellitus: a Danish retrospective cohort study with up to 17 years’ follow‐up

Diabetic Medicine ◽

10.1111/dme.14203 ◽

2019 ◽

Vol 37 (11) ◽

pp. 1861-1865

Author(s):

M. A. Nexø ◽

J. Pedersen ◽

B. Cleal ◽

J. B. Bjorner

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Disability Pension ◽

Retrospective Cohort ◽

Rate Of Return ◽

Increased Risk

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Type 1 and type 2 diabetes after gestational diabetes: a 23 year cohort study

Diabetologia ◽

10.1007/s00125-020-05215-3 ◽

2020 ◽

Vol 63 (10) ◽

pp. 2123-2128 ◽

Cited By ~ 1

Author(s):

Anna-Maaria Auvinen ◽

Kaisu Luiro ◽

Jari Jokelainen ◽

Ilkka Järvelä ◽

Mikael Knip ◽

...

Keyword(s):

Type 2 Diabetes ◽

Type 1 Diabetes ◽

Cohort Study ◽

Gestational Diabetes ◽

Fasting Glucose ◽

University Hospital ◽

Characteristic Analysis

Abstract Aims/hypothesis The aim of this work was to examine the progression to type 1 and type 2 diabetes after gestational diabetes mellitus (GDM) in a 23 year follow-up study. Methods We carried out a cohort study of 391 women with GDM diagnosed by an OGTT or the use of insulin treatment during pregnancy, and 391 age- and parity-matched control participants, who delivered in 1984–1994 at the Oulu University Hospital, Finland. Diagnostic cut-off levels for glucose were as follows: fasting, ≥4.8 mmol/l; 1 h, ≥10.0 mmol/l; and 2 h, ≥8.7 mmol/l. Two follow-up questionnaires were sent (in 1995–1996 and 2012–2013) to assess the progression to type 1 and type 2 diabetes. Mean follow-up time was 23.1 (range 18.7–28.8) years. Results Type 1 diabetes developed (5.7%) during the first 7 years after GDM pregnancy and was predictable at a 2 h OGTT value of 11.9 mmol/l during pregnancy (receiver operating characteristic analysis: AUC 0.91, sensitivity 76.5%, specificity 96.0%). Type 2 diabetes increased linearly to 50.4% by the end of the follow-up period and was moderately predictable with fasting glucose (AUC 0.69, sensitivity 63.5%, specificity 68.2%) at a level of 5.1 mmol/l (identical to the fasting glucose cut-off recommended by the International Association of Diabetes and Pregnancy Study Groups [IADPSG) and WHO]). Conclusions/interpretation All women with GDM should be intensively monitored for a decade, after which the risk for type 1 diabetes is minimal. However, the incidence of type 2 diabetes remains linear, and therefore individualised lifelong follow-up is recommended.

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