Increased purchases of prescription medicines in offspring of women with type 1 diabetes: a Finnish register-based cohort study between 1995 and 2018

Abstract

Objective This study aimed to assess whether in utero exposure to hyperglycemia influences prescription medicine purchases in the offspring of women with type 1 diabetes (exposed offspring).Patients/materials and methods We identified all singleton exposed offspring born in the hospital district of Helsinki and Uusimaa, Finland, between 1988 and 2011 from the Finnish Medical Birth Register, maintained by the Finnish Institute for Health and Welfare. For each exposed offspring, we obtained five age- and province-matched offspring of women without diabetes (reference offspring), from the Finnish Medical Birth Register. By combining data from three national registers, this longitudinal cohort study assessed prescription medicine purchases in exposed offspring (n = 1,725) and reference offspring (n = 8,755) from seven to thirty years of age. Prescription medicine purchases were grouped according to the Anatomical Therapeutic Chemical (ATC) classification system.Results Between 1995 and 2018, a total of 211,490 prescription medicines were purchased. After a median follow-up of 10.9 (interquartile range 4.9,17.6) years, we observed higher incidence risk ratios (IRR) of prescription medicine purchases for several ATC main groups in exposed offspring compared to reference offspring, with the highest IRR of 4.06 (95% CI: 2.78 to 5.94) for medicines affecting metabolism (e.g. diabetes medicines).Conclusion Our findings suggest that exposed offspring purchase more reimbursable prescription medicines than reference offspring from age seven to thirty years. More research is needed to examine the effects of intrauterine exposure to hyperglycemia on long-term health in offspring.

Keywords

• Offspring
• type 1 diabetes
• pregnancy
• morbidity
• prescription medicines