Notice bibliographique
Résumé
Gestational diabetes (GDM) is associated with excess weight gain and insulin resistance in offspring. Less is known about the association between GDM and diabetes incidence in youth. While type 2 diabetes (T2D) is the subtype of diabetes most consistently associated with insulin resistance, there is evidence that among those at risk immunologically for type 1 diabetes (T1D), insulin resistance may accelerate or precipitate its manifestation. This MSc Project examined the association between maternal GDM and overall diabetes incidence in adolescents and young adults. A retrospective cohort study was undertaken using both health administrative databases and birth and death registry data from the province of Quebec. Cohort inception was from April 1, 1990 to December 31, 1998, and follow-up from age 12 years to March 31, 2012, the developmental period when insulin resistance typically emerges. Randomly-selected singleton live births between April 1, 1990 and December 31, 1998 complicated by GDM were eligible for inclusion. These were 1:1 matched to those without GDM (i.e., matching by year of delivery, mother's age-group, and health region).The primary exposure was GDM in mothers, defined as one hospital discharge diagnosis and/or two outpatient physician claims for GDM within 6 months of delivery. The primary outcome was incident diabetes in youth, defined as one hospital discharge diagnosis and/or two outpatient visit diagnoses within a 2-year time period. The relationship between GDM status and diabetes in offspring was evaluated through survival analysis (Cox proportional hazard models).A total of 36,762 children were studied (mean birth weight 3,364g (SD 582g) with maternal GDM; 3,342g (SD 556g) without GDM in mothers). In total, 147 children were diagnosed with diabetes between 12 years of age and 2012 (maximum age 22 years).Diabetes incidence in offspring of mothers with GDM was more than twice as high as diabetes incidence in offspring of mothers without GDM, in both unadjusted (HR 2.25, 95% CI 1.56, 3.25) and adjusted models (HR 2.12, 95% CI 1.41, 3.17; with adjustment for sex, gestational age, birth weight, maternal education, ethnocultural origin, maternal age, maternal history of previous pregnancy, and stillbirth) This work conclusively demonstrates that GDM in mothers is associated with diabetes in youth. T1D and T2D cannot be distinguished in health administrative databases in Quebec. Given that T1D represents approximately 90% of diabetes cases in youth, our findings indirectly support the accelerator hypothesis (i.e., T1D develops earlier in a context of insulin resistance). The association between GDM and T2D in youth may be underestimated. In light of its strong association with diabetes in youth and young adulthood, maternal GDM may thus serve as an indicator to guide future strategies aimed at diabetes prevention and early disease detection.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,002 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,002 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,001 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,005 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».