Gestational diabetes and parental type 2 diabetes as risk indicators for type 1 diabetes in offspring: a systematic review and meta-analysisResearch in context

Summary: Background: Type 1 diabetes can be accelerated by insulin resistance, an increasingly prevalent condition. Some studies report an association between offspring type 1 diabetes development and insulin resistant parental diabetes, namely type 2 and gestational diabetes. We aimed to evaluate...

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Main Authors: Isabella Albanese, Laura Rendon, Meranda Nakhla, Elham Rahme, Kaberi Dasgupta
Format: Article
Language:English
Published: Elsevier 2025-07-01
Series:EClinicalMedicine
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Online Access:http://www.sciencedirect.com/science/article/pii/S2589537025002536
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author Isabella Albanese
Laura Rendon
Meranda Nakhla
Elham Rahme
Kaberi Dasgupta
author_facet Isabella Albanese
Laura Rendon
Meranda Nakhla
Elham Rahme
Kaberi Dasgupta
author_sort Isabella Albanese
collection DOAJ
description Summary: Background: Type 1 diabetes can be accelerated by insulin resistance, an increasingly prevalent condition. Some studies report an association between offspring type 1 diabetes development and insulin resistant parental diabetes, namely type 2 and gestational diabetes. We aimed to evaluate and synthesize this evidence, to delineate risk indicators for early detection and, potentially, for prevention. Methods: We conducted a systematic review and meta-analyses for studies assessing associations between gestational diabetes, maternal type 2 diabetes, and/or paternal type 2 diabetes, with offspring type 1 diabetes. We searched Embase, PubMed/Medline, Cochrane and Scopus from inception to April 30, 2025, without language restrictions. We assessed study quality, extracted summary data from published reports, and calculated pooled estimates using random effects models. Study Registration: ResearchRegistry (reviewregistry1606; April 27, 2023). Findings: Across 3205 studies screened, 18 were relevant, 11 of which we rated as moderate-to-high quality. Fifteen studies examined gestational diabetes, eight maternal type 2 diabetes, and seven paternal type 2 diabetes. Compared to no maternal diabetes, gestational diabetes was associated with a 94% risk increase for offspring type 1 diabetes (pooled OR 1·94, 95% CI 1·51–2·49; I2 = 86·9%). Compared to no paternal diabetes, paternal type 2 diabetes was associated with a 77% risk increase (pooled OR 1·77, 95% CI 1·17–2·69; I2 = 55·2%). The point estimate for maternal type 2 diabetes suggested the possibility of association with offspring type 1 diabetes but was inconclusive (pooled estimate 1·87, 95% CI 0·94–3·75; I2 = 71·9%). Interpretation: Gestational diabetes and paternal type 2 diabetes are offspring type 1 diabetes risk indicators. Including these conditions in family history assessments for patients with compatible symptoms may facilitate earlier diagnosis and reduce complications such as diabetic ketoacidosis. Funding: None.
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spelling doaj-art-bee5081207d54eb8bc0af859b3dcef862025-08-20T03:31:33ZengElsevierEClinicalMedicine2589-53702025-07-018510332110.1016/j.eclinm.2025.103321Gestational diabetes and parental type 2 diabetes as risk indicators for type 1 diabetes in offspring: a systematic review and meta-analysisResearch in contextIsabella Albanese0Laura Rendon1Meranda Nakhla2Elham Rahme3Kaberi Dasgupta4Department of Medicine, McGill University, Montreal, Quebec, Canada; Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre (MUHC), Montreal, Quebec, CanadaDepartment of Medicine, McGill University, Montreal, Quebec, Canada; Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre (MUHC), Montreal, Quebec, CanadaCentre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre (MUHC), Montreal, Quebec, Canada; Department of Pediatrics, McGill University, Montreal, Quebec, CanadaDepartment of Medicine, McGill University, Montreal, Quebec, Canada; Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre (MUHC), Montreal, Quebec, CanadaDepartment of Medicine, McGill University, Montreal, Quebec, Canada; Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre (MUHC), Montreal, Quebec, Canada; Corresponding author. Centre for Outcomes Research and Evaluation of the RI-MUHC, 5252 boul de Maisonneuve Ouest, Office 3E.09, Montréal, QC, H4A 3S5, Canada.Summary: Background: Type 1 diabetes can be accelerated by insulin resistance, an increasingly prevalent condition. Some studies report an association between offspring type 1 diabetes development and insulin resistant parental diabetes, namely type 2 and gestational diabetes. We aimed to evaluate and synthesize this evidence, to delineate risk indicators for early detection and, potentially, for prevention. Methods: We conducted a systematic review and meta-analyses for studies assessing associations between gestational diabetes, maternal type 2 diabetes, and/or paternal type 2 diabetes, with offspring type 1 diabetes. We searched Embase, PubMed/Medline, Cochrane and Scopus from inception to April 30, 2025, without language restrictions. We assessed study quality, extracted summary data from published reports, and calculated pooled estimates using random effects models. Study Registration: ResearchRegistry (reviewregistry1606; April 27, 2023). Findings: Across 3205 studies screened, 18 were relevant, 11 of which we rated as moderate-to-high quality. Fifteen studies examined gestational diabetes, eight maternal type 2 diabetes, and seven paternal type 2 diabetes. Compared to no maternal diabetes, gestational diabetes was associated with a 94% risk increase for offspring type 1 diabetes (pooled OR 1·94, 95% CI 1·51–2·49; I2 = 86·9%). Compared to no paternal diabetes, paternal type 2 diabetes was associated with a 77% risk increase (pooled OR 1·77, 95% CI 1·17–2·69; I2 = 55·2%). The point estimate for maternal type 2 diabetes suggested the possibility of association with offspring type 1 diabetes but was inconclusive (pooled estimate 1·87, 95% CI 0·94–3·75; I2 = 71·9%). Interpretation: Gestational diabetes and paternal type 2 diabetes are offspring type 1 diabetes risk indicators. Including these conditions in family history assessments for patients with compatible symptoms may facilitate earlier diagnosis and reduce complications such as diabetic ketoacidosis. Funding: None.http://www.sciencedirect.com/science/article/pii/S2589537025002536Type 1 diabetesGestational diabetesPaternal type 2 diabetesMaternal type 2 diabetesOffspring diabetes riskInsulin resistance
spellingShingle Isabella Albanese
Laura Rendon
Meranda Nakhla
Elham Rahme
Kaberi Dasgupta
Gestational diabetes and parental type 2 diabetes as risk indicators for type 1 diabetes in offspring: a systematic review and meta-analysisResearch in context
EClinicalMedicine
Type 1 diabetes
Gestational diabetes
Paternal type 2 diabetes
Maternal type 2 diabetes
Offspring diabetes risk
Insulin resistance
title Gestational diabetes and parental type 2 diabetes as risk indicators for type 1 diabetes in offspring: a systematic review and meta-analysisResearch in context
title_full Gestational diabetes and parental type 2 diabetes as risk indicators for type 1 diabetes in offspring: a systematic review and meta-analysisResearch in context
title_fullStr Gestational diabetes and parental type 2 diabetes as risk indicators for type 1 diabetes in offspring: a systematic review and meta-analysisResearch in context
title_full_unstemmed Gestational diabetes and parental type 2 diabetes as risk indicators for type 1 diabetes in offspring: a systematic review and meta-analysisResearch in context
title_short Gestational diabetes and parental type 2 diabetes as risk indicators for type 1 diabetes in offspring: a systematic review and meta-analysisResearch in context
title_sort gestational diabetes and parental type 2 diabetes as risk indicators for type 1 diabetes in offspring a systematic review and meta analysisresearch in context
topic Type 1 diabetes
Gestational diabetes
Paternal type 2 diabetes
Maternal type 2 diabetes
Offspring diabetes risk
Insulin resistance
url http://www.sciencedirect.com/science/article/pii/S2589537025002536
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AT elhamrahme gestationaldiabetesandparentaltype2diabetesasriskindicatorsfortype1diabetesinoffspringasystematicreviewandmetaanalysisresearchincontext
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