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Roth, Christian

Journal of Pediatric Endocrinology and Metabolism

Editor-in-Chief: Kiess, Wieland

Ed. by Bereket, Abdullah / Cohen, Pinhas / Darendeliler, Feyza / Dattani, Mehul / Gustafsson, Jan / Luo, Feihong / Mericq, Veronica / Toppari, Jorma

Editorial Board Member: Battelino, Tadej / Buyukgebiz, Atilla / Cassorla, Fernando / Chrousos, George P. / Cutfield, Wayne / Fideleff, Hugo L. / Hershkovitz, Eli / Hiort, Olaf / LaFranchi, Stephen H. / Lanes M. D., Roberto / Mohn, Angelika / Root, Allen W. / Rosenfeld, Ron G. / Werther, George / Zadik, Zvi

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The influence of exposure to maternal diabetes in utero on the rate of decline in β-cell function among youth with diabetes

1, a / Jeanette S. Andrews2, b / Ralph B. D’Agostino Jr.2, c / David J. Pettitt3, d / Elizabeth J. Mayer-Davis4, d / Jennifer R. Law4, d / Lawrence Dolan5, d / Jean M. Lawrence6, d / Sharon Saydah7, d / Carla Greenbaum8, d / Beatriz L. Rodriguez9, d / Dana Dabelea and the SEARCH for Diabetes in Youth Study Group1, e

1Department of Epidemiology, Colorado School of Public Health, University of Colorado, Denver, CO, USA

2Wake Forest School of Medicine, Winston-Salem, NC, USA

3Sansum Diabetes Research Institute, Santa Barbara, CA, USA

4University of North Carolina at Chapel Hill, School of Public Health and School of Medicine, Chapel Hill, NC, USA

5Cincinnati Children’s Hospital and the University of Cincinnati, Cincinnati, OH, USA

6Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA

7Centers for Disease Control and Prevention, Division of Diabetes Translation, Hyattsville, MD, USA

8Benaroya Research Institute at Virginia Mason, Seattle, WA, USA

9Kaukini Medical Center, Honolulu, HI, USA

aAdvised on analysis, and wrote the manuscript.

bConducted the analysis, and reviewed and edited the manuscript.

cAdvised on analysis, and reviewed and edited the manuscript.

dReviewed and edited the manuscript.

eAdvised on analysis, contributed to the discussion, and reviewed and edited the manuscript.

Corresponding author: Tessa L. Crume, PhD, MSPH, Department of Epidemiology, Colorado School of Public Health, University of Colorado Denver, 13001 East 17th Ave, Box B119, Aurora, CO 80045, USA, Phone: +1 303 724 4452, Fax: +1 303 724 4620

Citation Information: Journal of Pediatric Endocrinology and Metabolism. Volume 26, Issue 7-8, Pages 721–727, ISSN (Online) 2191-0251, ISSN (Print) 0334-018X, DOI: https://doi.org/10.1515/jpem-2012-0385, May 2013

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We explored the influence of exposure to maternal diabetes in utero on β cell decline measured by fasting C-peptide (FCP) among 1079 youth <20 years with diabetes, including 941 with type 1 and 138 with type 2 diabetes. Youths exposed to maternal diabetes had FCP levels that were 17% lower among youth with type 2 diabetes [95% confidence interval (CI): –34%, +6%] and 15% higher among youth with type 1 diabetes (95%CI: –14%, +55%) than their unexposed counterparts, although differences were not statistically significant (p=0.13 and p=0.35, respectively). Exposure to maternal diabetes was not associated with FCP decline in youth with type 2 (p=0.16) or type 1 diabetes (p=0.90); nor was the effect of in utero exposure on FCP modified by diabetes type. Findings suggest that exposure to maternal diabetes in utero may not be an important determinant of short-term β-cell function decline in youth with type 1 or type 2 diabetes.

Keywords: β-cell function; childhood type 2 diabetes; diabetes during pregnancy; fasting C-peptide; fetal exposure to diabetes; fetal overnutrition; gestational diabetes; type 1 diabetes

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