Albanese Isabella, Rendon Laura, Nakhla Meranda, Rahme Elham, Dasgupta Kaberi
Department of Medicine, McGill University, Montreal, Quebec, Canada.
Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre (MUHC), Montreal, Quebec, Canada.
EClinicalMedicine. 2025 Jul 4;85:103321. doi: 10.1016/j.eclinm.2025.103321. eCollection 2025 Jul.
Type 1 diabetes can be accelerated by insulin resistance, an increasingly prevalent condition. Some studies report an association between offspring type 1 diabetes development and insulin resistant parental diabetes, namely type 2 and gestational diabetes. We aimed to evaluate and synthesize this evidence, to delineate risk indicators for early detection and, potentially, for prevention.
We conducted a systematic review and meta-analyses for studies assessing associations between gestational diabetes, maternal type 2 diabetes, and/or paternal type 2 diabetes, with offspring type 1 diabetes. We searched Embase, PubMed/Medline, Cochrane and Scopus from inception to April 30, 2025, without language restrictions. We assessed study quality, extracted summary data from published reports, and calculated pooled estimates using random effects models. Study Registration: ResearchRegistry (reviewregistry1606; April 27, 2023).
Across 3205 studies screened, 18 were relevant, 11 of which we rated as moderate-to-high quality. Fifteen studies examined gestational diabetes, eight maternal type 2 diabetes, and seven paternal type 2 diabetes. Compared to no maternal diabetes, gestational diabetes was associated with a 94% risk increase for offspring type 1 diabetes (pooled OR 1·94, 95% CI 1·51-2·49; = 86·9%). Compared to no paternal diabetes, paternal type 2 diabetes was associated with a 77% risk increase (pooled OR 1·77, 95% CI 1·17-2·69; = 55·2%). The point estimate for maternal type 2 diabetes suggested the possibility of association with offspring type 1 diabetes but was inconclusive (pooled estimate 1·87, 95% CI 0·94-3·75; = 71·9%).
Gestational diabetes and paternal type 2 diabetes are offspring type 1 diabetes risk indicators. Including these conditions in family history assessments for patients with compatible symptoms may facilitate earlier diagnosis and reduce complications such as diabetic ketoacidosis.
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1型糖尿病可因胰岛素抵抗而加速发展，胰岛素抵抗是一种日益普遍的病症。一些研究报告了子代1型糖尿病的发生与胰岛素抵抗型父母糖尿病（即2型糖尿病和妊娠期糖尿病）之间的关联。我们旨在评估和综合这一证据，以确定早期检测以及可能用于预防的风险指标。
我们对评估妊娠期糖尿病、母亲2型糖尿病和/或父亲2型糖尿病与子代1型糖尿病之间关联的研究进行了系统评价和荟萃分析。我们检索了从创刊至2025年4月30日的Embase、PubMed/Medline、Cochrane和Scopus数据库，无语言限制。我们评估了研究质量，从已发表的报告中提取汇总数据，并使用随机效应模型计算合并估计值。研究注册：ResearchRegistry（reviewregistry1606；2023年4月27日）。
在筛查的3205项研究中，18项相关，其中11项我们评为中高质量。15项研究考察了妊娠期糖尿病，8项考察了母亲2型糖尿病，7项考察了父亲2型糖尿病。与母亲无糖尿病相比，妊娠期糖尿病与子代1型糖尿病风险增加94%相关（合并比值比1.94，95%置信区间1.51 - 2.49；I² = 86.9%）。与父亲无糖尿病相比，父亲2型糖尿病与风险增加77%相关（合并比值比1.77，95%置信区间1.17 - 2.69；I² = 55.2%）。母亲2型糖尿病的点估计值表明可能与子代1型糖尿病有关联，但尚无定论（合并估计值1.87，95%置信区间0.94 - 3.75；I² = 71.9%）。
妊娠期糖尿病和父亲2型糖尿病是子代1型糖尿病的风险指标。在有相关症状的患者的家族史评估中纳入这些病症，可能有助于更早诊断并减少糖尿病酮症酸中毒等并发症。
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