Long-term Cognitive Implications of Intrauterine Hyperglycemia in Adolescent Offspring of Women With Type 1 Diabetes (the EPICOM Study)

Birgitte Bytoft, Sine Knorr, Zuzana Vlachova, Rikke B Jensen, Elisabeth R Mathiesen, Henning Beck-Nielsen, Claus H Gravholt, Dorte M Jensen, Tine D Clausen, Erik L Mortensen, Peter Damm

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Resumé

OBJECTIVE: Exposure to maternal diabetes in utero may have a negative impact on the developing brain. The objective was to examine long-term cognitive consequences of intrauterine hyperglycemia in adolescent offspring of women with type 1 diabetes and to ascertain a possible association with maternal HbA1c.

RESEARCH DESIGN AND METHODS: Offspring of a prospectively followed cohort of women with type 1 diabetes (n = 277) participated in a follow-up examination at the age of 13-19 years. A control group from the background population was identified (n = 301). Cognitive function was evaluated using Reynolds Intellectual Assessment Scales and classified into indices of composite intelligence, verbal and nonverbal intelligence, and composite memory. Frequencies of reading and writing problems and attendance to classes for children with learning difficulties were assessed.

RESULTS: Offspring of women with type 1 diabetes scored lower in all normalized and standardized intelligence indices compared with controls: composite intelligence (95.7 vs. 100, P = 0.001), verbal intelligence (96.2 vs. 100, P = 0.004), nonverbal intelligence (96.4 vs. 100, P = 0.008), and composite memory (95.7 vs. 100, P = 0.001). A higher frequency of diabetes-exposed offspring had parent-reported learning difficulties in primary school. Differences between groups remained after adjustment for confounders and potential mediators. We found no direct association between maternal HbA1c and offspring cognitive function in the exposed group.

CONCLUSIONS: Adolescent offspring of women with type 1 diabetes had lower cognitive function compared with a control group, also after adjustment for confounders and potential mediators. These differences may reflect direct harmful effects of maternal diabetes on neurodevelopment in the offspring.

OriginalsprogEngelsk
TidsskriftDiabetes Care
Vol/bind39
Udgave nummer8
Sider (fra-til)1356-1363
ISSN0149-5992
DOI
StatusUdgivet - 2016

Fingeraftryk

Hyperglycemia
Cognition
Mothers
Maternal Exposure
Control Groups
Reading
Population

Citer dette

Bytoft, Birgitte ; Knorr, Sine ; Vlachova, Zuzana ; Jensen, Rikke B ; Mathiesen, Elisabeth R ; Beck-Nielsen, Henning ; Gravholt, Claus H ; Jensen, Dorte M ; Clausen, Tine D ; Mortensen, Erik L ; Damm, Peter. / Long-term Cognitive Implications of Intrauterine Hyperglycemia in Adolescent Offspring of Women With Type 1 Diabetes (the EPICOM Study). I: Diabetes Care. 2016 ; Bind 39, Nr. 8. s. 1356-1363.
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title = "Long-term Cognitive Implications of Intrauterine Hyperglycemia in Adolescent Offspring of Women With Type 1 Diabetes (the EPICOM Study)",
abstract = "OBJECTIVE: Exposure to maternal diabetes in utero may have a negative impact on the developing brain. The objective was to examine long-term cognitive consequences of intrauterine hyperglycemia in adolescent offspring of women with type 1 diabetes and to ascertain a possible association with maternal HbA1c.RESEARCH DESIGN AND METHODS: Offspring of a prospectively followed cohort of women with type 1 diabetes (n = 277) participated in a follow-up examination at the age of 13-19 years. A control group from the background population was identified (n = 301). Cognitive function was evaluated using Reynolds Intellectual Assessment Scales and classified into indices of composite intelligence, verbal and nonverbal intelligence, and composite memory. Frequencies of reading and writing problems and attendance to classes for children with learning difficulties were assessed.RESULTS: Offspring of women with type 1 diabetes scored lower in all normalized and standardized intelligence indices compared with controls: composite intelligence (95.7 vs. 100, P = 0.001), verbal intelligence (96.2 vs. 100, P = 0.004), nonverbal intelligence (96.4 vs. 100, P = 0.008), and composite memory (95.7 vs. 100, P = 0.001). A higher frequency of diabetes-exposed offspring had parent-reported learning difficulties in primary school. Differences between groups remained after adjustment for confounders and potential mediators. We found no direct association between maternal HbA1c and offspring cognitive function in the exposed group.CONCLUSIONS: Adolescent offspring of women with type 1 diabetes had lower cognitive function compared with a control group, also after adjustment for confounders and potential mediators. These differences may reflect direct harmful effects of maternal diabetes on neurodevelopment in the offspring.",
author = "Birgitte Bytoft and Sine Knorr and Zuzana Vlachova and Jensen, {Rikke B} and Mathiesen, {Elisabeth R} and Henning Beck-Nielsen and Gravholt, {Claus H} and Jensen, {Dorte M} and Clausen, {Tine D} and Mortensen, {Erik L} and Peter Damm",
note = "{\circledC} 2016 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered.",
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pages = "1356--1363",
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Bytoft, B, Knorr, S, Vlachova, Z, Jensen, RB, Mathiesen, ER, Beck-Nielsen, H, Gravholt, CH, Jensen, DM, Clausen, TD, Mortensen, EL & Damm, P 2016, 'Long-term Cognitive Implications of Intrauterine Hyperglycemia in Adolescent Offspring of Women With Type 1 Diabetes (the EPICOM Study)', Diabetes Care, bind 39, nr. 8, s. 1356-1363. https://doi.org/10.2337/dc16-0168

Long-term Cognitive Implications of Intrauterine Hyperglycemia in Adolescent Offspring of Women With Type 1 Diabetes (the EPICOM Study). / Bytoft, Birgitte; Knorr, Sine; Vlachova, Zuzana; Jensen, Rikke B; Mathiesen, Elisabeth R; Beck-Nielsen, Henning; Gravholt, Claus H; Jensen, Dorte M; Clausen, Tine D; Mortensen, Erik L; Damm, Peter.

I: Diabetes Care, Bind 39, Nr. 8, 2016, s. 1356-1363.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

TY - JOUR

T1 - Long-term Cognitive Implications of Intrauterine Hyperglycemia in Adolescent Offspring of Women With Type 1 Diabetes (the EPICOM Study)

AU - Bytoft, Birgitte

AU - Knorr, Sine

AU - Vlachova, Zuzana

AU - Jensen, Rikke B

AU - Mathiesen, Elisabeth R

AU - Beck-Nielsen, Henning

AU - Gravholt, Claus H

AU - Jensen, Dorte M

AU - Clausen, Tine D

AU - Mortensen, Erik L

AU - Damm, Peter

N1 - © 2016 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered.

PY - 2016

Y1 - 2016

N2 - OBJECTIVE: Exposure to maternal diabetes in utero may have a negative impact on the developing brain. The objective was to examine long-term cognitive consequences of intrauterine hyperglycemia in adolescent offspring of women with type 1 diabetes and to ascertain a possible association with maternal HbA1c.RESEARCH DESIGN AND METHODS: Offspring of a prospectively followed cohort of women with type 1 diabetes (n = 277) participated in a follow-up examination at the age of 13-19 years. A control group from the background population was identified (n = 301). Cognitive function was evaluated using Reynolds Intellectual Assessment Scales and classified into indices of composite intelligence, verbal and nonverbal intelligence, and composite memory. Frequencies of reading and writing problems and attendance to classes for children with learning difficulties were assessed.RESULTS: Offspring of women with type 1 diabetes scored lower in all normalized and standardized intelligence indices compared with controls: composite intelligence (95.7 vs. 100, P = 0.001), verbal intelligence (96.2 vs. 100, P = 0.004), nonverbal intelligence (96.4 vs. 100, P = 0.008), and composite memory (95.7 vs. 100, P = 0.001). A higher frequency of diabetes-exposed offspring had parent-reported learning difficulties in primary school. Differences between groups remained after adjustment for confounders and potential mediators. We found no direct association between maternal HbA1c and offspring cognitive function in the exposed group.CONCLUSIONS: Adolescent offspring of women with type 1 diabetes had lower cognitive function compared with a control group, also after adjustment for confounders and potential mediators. These differences may reflect direct harmful effects of maternal diabetes on neurodevelopment in the offspring.

AB - OBJECTIVE: Exposure to maternal diabetes in utero may have a negative impact on the developing brain. The objective was to examine long-term cognitive consequences of intrauterine hyperglycemia in adolescent offspring of women with type 1 diabetes and to ascertain a possible association with maternal HbA1c.RESEARCH DESIGN AND METHODS: Offspring of a prospectively followed cohort of women with type 1 diabetes (n = 277) participated in a follow-up examination at the age of 13-19 years. A control group from the background population was identified (n = 301). Cognitive function was evaluated using Reynolds Intellectual Assessment Scales and classified into indices of composite intelligence, verbal and nonverbal intelligence, and composite memory. Frequencies of reading and writing problems and attendance to classes for children with learning difficulties were assessed.RESULTS: Offspring of women with type 1 diabetes scored lower in all normalized and standardized intelligence indices compared with controls: composite intelligence (95.7 vs. 100, P = 0.001), verbal intelligence (96.2 vs. 100, P = 0.004), nonverbal intelligence (96.4 vs. 100, P = 0.008), and composite memory (95.7 vs. 100, P = 0.001). A higher frequency of diabetes-exposed offspring had parent-reported learning difficulties in primary school. Differences between groups remained after adjustment for confounders and potential mediators. We found no direct association between maternal HbA1c and offspring cognitive function in the exposed group.CONCLUSIONS: Adolescent offspring of women with type 1 diabetes had lower cognitive function compared with a control group, also after adjustment for confounders and potential mediators. These differences may reflect direct harmful effects of maternal diabetes on neurodevelopment in the offspring.

U2 - 10.2337/dc16-0168

DO - 10.2337/dc16-0168

M3 - Journal article

C2 - 27271191

VL - 39

SP - 1356

EP - 1363

JO - Diabetes Care

JF - Diabetes Care

SN - 0149-5992

IS - 8

ER -