Abstract
Aims/hypothesisGenetic and environmental factors are believed to cause type 1 diabetes. The aim of this study was to investigate the influence of maternal BMI and gestational weight gain on the subsequent risk of childhood type 1 diabetes.MethodsChildren in the Swedish National Quality Register for Diabetes in Children were matched with control children from the Swedish Medical Birth Register. Children were included whose mothers had data available on BMI in early pregnancy and gestational weight gain, giving a total of 16,179 individuals: 3231 children with type 1 diabetes and 12,948 control children.ResultsMothers of children with type 1 diabetes were more likely to be obese (9% [n = 292/3231] vs 7.7% [n = 991/12,948]; p = 0.02) and/or have diabetes themselves (2.8% [n = 90/3231] vs 0.8% [n = 108/12,948]; p < 0.001) compared with mothers of control children. Gestational weight gain did not differ significantly between the two groups of mothers. In mothers without diabetes, maternal obesity was a significant risk factor for type 1 diabetes in the offspring (p = 0.04). A child had an increased risk of developing type 1 diabetes if the mother had been obese in early pregnancy (crude OR 1.20; 95% CI 1.05, 1.38; adjusted OR 1.18; 95% CI 1.02, 1.36). Among children with type 1 diabetes (n = 3231) there was a difference (p < 0.001) in age at onset in relation to the mother’s BMI. Among children in the oldest age group (15–19 years), there were more mothers who had been underweight during pregnancy, while in the youngest age group (0–4 years) the pattern was reversed.Conclusions/interpretationMaternal obesity, in the absence of maternal diabetes, is a risk factor for type 1 diabetes in the offspring, and influences the age of onset of type 1 diabetes. This emphasises the importance of a normal maternal BMI to potentially decrease the incidence of type 1 diabetes.
Highlights
Type 1 diabetes is one of the most common chronic diseases in children and young adults, and the incidence has increased worldwide in recent decades [1, 2]
Conclusions/interpretation Maternal obesity, in the absence of maternal diabetes, is a risk factor for type 1 diabetes in the offspring, and influences the age of onset of type 1 diabetes. This emphasises the importance of a normal maternal BMI to potentially decrease the incidence of type 1 diabetes
Further analysis showed that underweight mothers with an inadequate gestational weight gain were less likely to have a child who developed type 1 diabetes compared with underweight mothers with adequate (p = 0.04) or excessive (p = 0.04) gestational weight gain
Summary
Type 1 diabetes is one of the most common chronic diseases in children and young adults, and the incidence has increased worldwide in recent decades [1, 2]. Since the 1980s, the increase has been around 3% annually and the disease currently affects about 500,000 children worldwide [3]. Second to Finland, Sweden has the highest incidence of type 1 diabetes in the world [2]. Sweden are diagnosed with type 2 diabetes [4]. The aetiology of type 1 diabetes is multifactorial, and both genetic and environmental factors are thought to contribute [5]. The period in which the rapid increase has occurred is too short to be explained by genetic shifts, and is believed to be influenced by environmental factors [6]
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