Bibliographic record
Abstract
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.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.005 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".