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Faculty have requested this content not be shared on social media
CME Credit Offered
CME Credit Offered
Abstract Award
Abstract Award
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Poster Session 2

(643) Clinical outcomes in pregnant people with type 1 diabetes: does age of diabetes onset matter?

Thursday, January 30, 2025
4:00 PM – 6:00 PM  
Objective:

Metabolic differences exist between childhood- and adult-onset type 1 diabetes mellitus (T1DM), yet how these may be associated with perinatal outcomes is poorly understood. We aimed to evaluate the association of age of onset of T1DM with antenatal glycemic control and perinatal outcomes.

Study Design:

In this single-center retrospective cohort study (2018-2023), we compared pregnant people with childhood- (< 18 years of age) vs. adult-onset (≥18 years of age) T1DM who used a continuous glucose monitor (CGM). We assessed maternal (gestational weight gain [GWG], hypertensive disorders of pregnancy [HDP], cesarean birth), neonatal (preterm birth [PTB], large-for-gestational age, neonatal intensive care unit admission, hypoglycemia), and glycemic outcomes (CGM metrics, hemoglobin A1c [HbA1c]; by trimester). Multivariable logistic and linear regression were used to determine adjusted odds ratios (aOR) or β-coefficients (β) and 95% confidence intervals (CI), adjusted for pre-gravid body mass index (BMI).

Results:

Of 102 eligible individuals, 61 (60%) had childhood-onset T1DM. Individuals with childhood-onset (vs. adult-onset) T1DM were younger (32 vs. 35 years old, p=0.01) and had higher pre-gravid BMI (26 vs. 24 kg/m2, p=0.01). Although HDP was more frequent among those with childhood-onset T1DM (39% vs. 27%), adjusted odds of all maternal outcomes were similar by age of onset (Table 1). The adjusted odds of PTB (aOR 3.48 [95% CI 1.02, 11.8]) were higher in individuals with childhood-onset, compared to those with adult-onset T1DM, but all other neonatal outcomes were similar. Childhood-onset (vs. adult-onset) T1DM was associated with lower 1st trimester time-in-range (57% vs. 65%, β -7.36 [95% CI 0.63, 14.08]); all other per-trimester glycemic metrics were similar between groups (Table 2).

Conclusion:

Childhood-onset, compared to adult-onset, T1DM is associated with higher odds of PTB, but similar glycemic control in pregnancy aside from lower 1st trimester TIR. These findings may inform risk counseling and surveillance in those with childhood-onset T1DM to mitigate risk of adverse perinatal outcomes.