Children of mothers with type 1 diabetes are more likely to get ASD diagnosis

Women with type 1 diabetes have significantly elevated odds of having a child with an autism spectrum disorder (ASD), according to new research. 

To determine the potential influence of any type of maternal diabetes on the risk for ASD, Anny Xiang and colleagues analyzed data collected on more than 400,000 children born in Kaiser Permanente Southern California hospitals over a 17-year period. The researchers used electronic medical records to identify children later diagnosed with ASD. In addition, they used an algorithm developed for electronic health records data to identify mothers with type 1 diabetes, type 2 diabetes, or gestational diabetes that developed either early or late in pregnancy. They confirmed diabetes diagnoses for the mothers by looking for the prescription of insulin during pregnancy. 

Adjusting their data to control for a wide range of factors, the researchers found that mothers with type 1 diabetes had more than double the odds of having a child with ASD compared to non-diabetic mothers. Mothers with type 2 diabetes or early gestational diabetes (diagnosed by 26 weeks of pregnancy) also had a higher risk, but it was significantly less than for mothers with type 1 diabetes. Late gestational diabetes (diagnosed after 26 weeks) was not associated with any increase in ASD in children. Within the gestational diabetes group, maternal exposure to antidiabetic medication during pregnancy did not affect children’s ASD risk. 

Xiang says the findings emphasize that “it is important for both patient and clinician to monitor glucose control as carefully as possible and make sure it is normal right from the time of conception.” 

Commenting on the findings, physician Peter Damm, who was not involved in the study, says, “The finding that type 1 diabetes in pregnancy has a higher hazard ratio for autism than type 2 diabetes, and more so again than gestational diabetes, reflects the degree of maternal hyperglycemia and seems reasonable. Likewise, the finding that women diagnosed with gestational diabetes early as opposed to late have a higher risk, showing us a dose-response relationship with regard to different types of diabetes and autism risk.”

Citations

“Type 1 diabetes in pregnancy doubles risk for autism in offspring,” Becky McCall, Medscape, June 25, 2018. Xiang et al. reported their findings at the 2018 conference of the American Diabetes Association in June 2018.