222 / 244
had an adjusted odds ratio (aOR) 1.18 higher risk for total
congenital malformations in their first offspring in compari-
son with non-GDM mothers. The aOR for ear/face/neck
defects, congenital heart defects, urinary/renal agenesis and
limb defects were 1.49, 1.24, 1.42 and 1.31 respectively in their
offspring for GDM mothers when compared to non-GDM
mothers.
GDM mothers who were treated with insulin had higher risks
for total CMs in their offspring when compared with GDM
mothers who were on diet control. This was especially true in
birth defects of nervous system defects, ear/face/neck defects,
congenital heart defects, respiratory defects, oro
‐
facial clefts,
urinary/renal agenesis and chromosome abnormality.
Conclusion:
GDM mothers confer higher risk for CMs in their
first offspring when compared with non-GDM mothers. GDM
mothers who were treated with insulin also having higher
risks for total CMs than those who were on diet control,
indicated that the severity of glycemic status might relate to
the offspring outcome. The results of this study imply the
mandatory for GDM management during pregnancy.
PJ-39
Relationship between pre-gestational diabetes and birth
defects in the first offspring in Taiwan
–
a nationwide survey
Chien-Ning HUANG
1,2
, Ying-Hsiang CHOU
3
, Jia-Yuh CHEN
4,5
,
Pen-Hua SU
4,5
, Chih-Jen TSENG
6
, Yung-Po LIAW
7
,
Ya-Fang TSAI
8
, Yi-Chang LI
8
, Ting-Huan CHANG
8
,
Charles Tzu-Chi LEE
9
, Suh-Jen CHEN
4,10
, Cheng-Hung LIN
11
,
Guan-Ming CHEN
5
, Pei-Syuan CHIANG
5
, Yu-Jhen HONG
8
,
Jeng-Yuan CHIOU
8
*.
1
Endocrinology and Metabolism, Chung Shan
Medical University Hospital,
2
Institute of Medicine, Chung Shan
Medical University,
3
School of Medical Imaging and Radiological
Sciences, Chung Shan Medical University,
4
Department of Pediatrics,
Chung Shan Medical University Hospital,
5
Department of Pediatrics,
School of Medicine, Chung Shan Medical University,
6
Department of
Obstetrics and Gynecology, Chung Shan Medical University Hospital,
Taichung,
7
Department of Public Health and Institute of Public
Health, Chung Shan Medical University,
8
School of Health Policy and
Management, Chung Shan Medical University, Taichung,
9
Department of Health Promotion and Health Education, National
Taiwan Normal University, Taipei,
10
School of Nursing, Chung Shan
Medical University,
11
Information Center, Chung Shan Medical
University Hospital, Taichung, Taiwan
Background:
The literature had shown that women with pre-
gestational diabetes significantly increased birth defect (BD) in
their offspring. In Taiwan the incidence of BDwere around 0.2
–
0.45%. The relation between pre-gestational diabetes and BD in
Taiwan however remains unknown at large.
Objective:
By using a national representative, this study aimed
to investigate the relation of BD risk in the first-offspring with
singleton birth among pre-gestational diabetes, suspect-
diabetes and non-diabetes mothers, and to explore the
association among BD risk and maternal age, neonatal
gender, gestational age, birth weight and Apgar score.
Methods:
A dataset during 2004 to 2009 from National Health
Insurance Research Database, the Birth Registration database
and the Birth Certificate Application were applied. Pre-
gestational diabetes was defined by three or more outpatient
visits with diabetes diagnostic codes (ICD-9-CM 250) 300 days
before delivery day or by one inpatient discharge code. Those
with only one or two outpatient visits with diabetes diagnostic
codes were deemed as suspect-diabetes, while those without
any were non-diabetes. Those who had delivered newborns
(n = 188,798) before 2004, and thosewho had been diagnosed as
gestational diabetes (n = 19,430) were excluded. A total 3,356
pregnant women with pre-gestational diabetes, 60,909 with
suspect-diabetes and 556,743withnon-diabeteswere recruited
for analysis. Maternal age, gestational weeks, urbanization and
CCI were adjusted to obtain BD risk odds ratio (aOR).
Results:
Offspring from women with pre-gestational diabetes
significantly increased the risk of BD when compared to those
from non-diabetes mothers (aOR 1.83). The defects included
the nervous system, eyes, heart, respiratory system, orofacial
cleft, GI system, urinary tract system and limb with aOR 1.82,
2.12, 1.94, 1.82, 2.40, 1.65, 1.75 and 2.15 respectively. Offspring
from suspect-diabetes mother had only mild increased risk of
heart defect (aOR 1.14) when compared to those from non-
diabetes mothers. The decreased risk of BD was associated
with the increase of gestation weeks, birth weight and the 1st,
5th
–
min Apgar score of newborn. The increase in maternal
age, the increase in BD risk was found. In addition, the BD risk
in boys was significantly higher than in girls.
Conclusion:
Women with pre-gestational diabetes and higher
maternal age raise the risk of BD in their offspring. Cautious
prenatal counseling and comprehensive diabetes manage-
ment are mandatory for these populations.
PJ-40
The relationship of glycemic exposure (HbAlc) to the risk of
subclinical hypothyroidism in type 2 diabetes mellitus
patients
Hari HENDARTO
1,2
*, Aswin PRAMONO
2
, Dante SAKSONO
2
,
Imam SUBEKTI
2
, Siti SETIATI
2
.
1
Department of Internal Medicine,
Faculty of Medicine and Health Science UIN Syarif Hidayatullah
Jakarta,
2
Department of Internal Medicine, Faculty of Medicine
University of Indonesia, Indonesia
Background:
Patients with subclinical hypothyroidism (SCH)
sustain an obvious increase in cardiovascular event rates.
Abundant evidence suggests a link between SCH and type 2
diabetes mellitus (T2DM). How is the relationship between
glycemic control (HbA1c) with SCH in T2DM patients in
Indonesia, is still unknown.
Objective:
To determine the proportion of SCH in patients with
T2DM and to know the relationship between HbAlc with SCH
in patients with T2DM.
Methods:
Two hundred and seventy-eight adult patients with
T2DM were included in the study. Data retrieved frommedical
records and laboratory tests. Patients who have been diag-
nosed with T2DM at least 1 year, who had no previous history
of thyroid disease fromoutpatient depatment of CiptoMangun
Kusumo Hospital, Jakarta, Indonesia, retrieved data of HbAlc
and thyroid hormones. Those with normal free triiodothyron-
ine (FT3), free thyroxine (FT4), and an increased TSH level were
diagnosed with SCH.
Results:
The proportion of SCH in patients with T2DM 7.2%,
mostly aged over 60 years. There were no differences in the
proportion between men and women. From the analysis
reveals the T2DM patients with HbA1C > 7 had 3.664 times
greater risk of developing SCH compared with T2DM patients
with well glycemic control.
Conclusions:
There was a significant relationship between
HbAlc with SCH events in patients with T2DM.
PJ-41
Infection with hepatitis C virus increases the incidence of
dialysis in patients with type 2 diabetes
Yi-Jing SHEEN
1
, Wayne H-H SHEU
2
, Wei-Yin KUO
3
,
Pei-Tseng KUNG
4
, Wen-Chen TSAI
3
*.
1
Division of Endocrinology
and Metabolism, Department of Internal Medicine, Taichung
Hospital, Ministry of Health and Welfare,
2
Division of Endocrinology
and Metabolism, Department of Internal Medicine, Taichung
Veterans General Hospital,
3
Department of Health Services
Administration, China Medical University,
4
Department of
Healthcare Administration, Asia University, Taiwan
Background:
Type 2 diabetes mellitus (T2DM) and hepatitis C
virus (HCV) infection are unsolved public health issues, and
patients with both these diseases are at a higher risk for
chronic kidney disease. We aimed to investigate the influence
Poster Presentations / Diabetes Research and Clinical Practice 120S1 (2016) S65
–
S211
S204