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Size at Birth, Growth in Childhood, and the Risk for Type 2 Diabetes
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What is the problem and what is known about it so far?
Insulin is a hormone that regulates how the body uses carbohydrates, protein, and fat. In type 2 (adult-onset) diabetes, the body's tissues lose their sensitivity to insulin. To overcome this resistance, the body puts out more insulin, leading to high levels of insulin in the bloodstream. When even these levels of insulin fail to overcome the tissue resistance, high levels of blood sugar (glucose) develop. Overweight adults are at increased risk for type 2 diabetes. Recently, it has been suggested that being small at birth increases the risk for type 2 diabetes later in life. It is therefore possible that people who develop type 2 diabetes have a particular path of growth from birth through adulthood.
Why did the researchers do this particular study?
To study the relationship of type 2 diabetes to size at birth and growth in childhood.
Who was studied?
The researchers studied 3639 men and 3447 women who were born at Helsinki University Central Hospital in Finland from 1924 to 1933, went to school in Helsinki, and were still living in Finland in 1971.
How was the study done?
The researchers used detailed birth and health records to track the study participants' growth patterns. Finland's register of all people who take long-term medicines also allowed them to identify study patients who developed type 2 diabetes. The researchers then compared growth patterns in persons who did and did not develop type 2 diabetes.
What did the researchers find?
Of the 7086 study participants, 471 developed type 2 diabetes. Low birth size was associated with the later development of type 2 diabetes. By age 7, the average height and weight of persons who later developed diabetes were about the same as those of persons who did not develop diabetes. The rate of growth between ages 7 and 15 years was accelerated, however, in persons who later developed type 2 diabetes compared with the growth rate in persons who did not later develop diabetes.
What were the limitations of the study?
This study relied on the information available in birth, school health, and insurance records. It is possible that factors other than birth size and childhood growth might be even stronger predictors of late-onset diabetes, but the researchers did not have information about those factors.
What are the implications of the study?
The findings of this study support possibility that type 2 diabetes is somehow “programmed” in response to low growth during fetal development followed by accelerated growth later on in childhood.
Article and Author Information
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The summary below is from the full report titled “The Fetal and Childhood Growth of Persons Who Develop Type 2 Diabetes.” It is in the 1 August 2000 issue of Annals of Internal Medicine (volume 133, pages 176-182). The authors are T. Forsén, J. Eriksson, J. Tuomilehto, A. Reunanen, C. Osmond, and D. Barker.
- Copyright ©2004 by the American College of Physicians
