Caucasian and Asian difference in role of type 1 diabetes on large-for-gestational-age neonates

IntroductionRacial differences in the association between type 1 diabetes mellitus (T1DM) and large-for-gestational-age (LGA) neonates remain unclear. The objective of this study was to compare the effect of T1DM on LGA neonates between Caucasian and Asian women.Research design and methodsA population-based retrospective cohort study was conducted among Caucasian and Asian women who had prenatal screening and gave a singleton live birth in an Ontario hospital between April 2015 and March 2018. Multivariable log-binomial regression models were used to estimate the adjusted relative risks (aRRs) and 95% CIs of T1DM on LGA for Caucasian and Asian women. Relative contribution of T1DM to LGA was examined by multivariable logistic regression model, stratified by Caucasian and Asian women.ResultsA total of 232 503 women (69.4% Caucasians and 30.6% Asians) were included in the final analysis. The rate of T1DM was higher in Caucasians (0.5%) than in Asians (0.2%), and the rate of LGA neonates was also higher in Caucasians (11.0%) than in Asians (5.0%). The association between T1DM and LGA in Caucasians (aRR 4.18, 95% CI (3.84 to 4.55)) was more robust than that in Asians (aRR 2.11, 95% CI (1.24 to 3.59)). T1DM was the fourth strongest contributor to LGA in Caucasians, while T1DM was the seventh contributor to LGA in Asians.ConclusionsT1DM plays a more substantial role in LGA among Caucasians than Asians. Clinicians should be aware of the Caucasian–Asian differences of effects of T1DM on LGA when developing pregnancy management strategies.

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Association between gestational glycemic profile and delivery with a large for gestational age baby in pregnant women with type 1 diabetes

Endocrine Abstracts ◽

10.1530/endoabs.70.aep266 ◽

2020 ◽

Author(s):

Ekaterine Inashvili ◽

Natalia Asatiani ◽

Ramaz Kurashvili ◽

Elena Shelestova ◽

Mzia Dundua ◽

...

Keyword(s):

Type 1 Diabetes ◽

Pregnant Women ◽

Gestational Age ◽

Large For Gestational Age ◽

Glycemic Profile

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Gestational glycemia in association with delivery with a large for gestational age baby in women with type 1 diabetes

10.26226/morressier.5d9b6233ea541d6ca8494363 ◽

2019 ◽

Author(s):

Inashvili Ekaterine

Keyword(s):

Type 1 Diabetes ◽

Gestational Age ◽

Large For Gestational Age

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Glycemic Excursions in Type 1 Diabetes in Pregnancy: A Semiparametric Statistical Approach to Identify Sensitive Time Points during Gestation

Journal of Diabetes Research ◽

10.1155/2017/2852913 ◽

2017 ◽

Vol 2017 ◽

pp. 1-7 ◽

Cited By ~ 7

Author(s):

Resmi Gupta ◽

Jane Khoury ◽

Mekibib Altaye ◽

Lawrence Dolan ◽

Rhonda D. Szczesniak

Keyword(s):

Type 1 Diabetes ◽

Blood Glucose ◽

Gestational Age ◽

Glucose Monitoring ◽

Large For Gestational Age ◽

Optimal Timing ◽

Care Providers ◽

Delivery Outcome ◽

Glucose Levels

Aim.To examine the gestational glycemic profile and identify specific times during pregnancy that variability in glucose levels, measured by change in velocity and acceleration/deceleration of blood glucose fluctuations, is associated with delivery of a large-for-gestational-age (LGA) baby, in women with type 1 diabetes.Methods.Retrospective analysis of capillary blood glucose levels measured multiple times daily throughout gestation in women with type 1 diabetes was performed using semiparametric mixed models.Results.Velocity and acceleration/deceleration in glucose levels varied across gestation regardless of delivery outcome. Compared to women delivering LGA babies, those delivering babies appropriate for gestational age exhibited significantly smaller rates of change and less variation in glucose levels between 180 days of gestation and birth.Conclusions.Use of innovative statistical methods enabled detection of gestational intervals in which blood glucose fluctuation parameters might influence the likelihood of delivering LGA baby in mothers with type 1 diabetes. Understanding dynamics and being able to visualize gestational changes in blood glucose are a potentially useful tool to assist care providers in determining the optimal timing to initiate continuous glucose monitoring.

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