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Type 2 Diabetes Risk May Begin Before Birth


Could the susceptibility to type 2 diabetes begin before birth? The results of a new primate study suggest that mothers who fail to get enough nourishment during pregnancy and breastfeeding consistently have offspring who develop prediabetes before adolescence.

Poor fetal nutrition may set up type 2 diabetes

Type 2 diabetes, formerly called adult-onset diabetes, has been developing in a growing number of adolescents and even children. The chronic disease occurs when the body develops insulin resistance, a condition which prevents the body from properly regulating or utilizing the hormone to maintain healthy blood sugar levels. When blood sugar levels are not well controlled, serious and life-threatening complications can arise, including heart disease, blindness, kidney failure, neuropathy, and stroke.

The American Diabetes Association released new statistics in January 2011, noting that there are 25.8 million (8.3% of the population) children and adults with diabetes, and an additional 79 million who have prediabetes. Globally, the World Health Organization estimates there will be 366 million people with the disease by 2030.

Known causes of type 2 diabetes include overweight/obesity and a sedentary lifestyle, but researchers have also been looking for other factors, especially early in life. Peter W. Nathanelsz, of the Center for Pregnancy and Newborn Research in the UT Health Science Center’s Department of Obstetrics and Gynecology, and his colleagues from UT Health Science Center at San Antonio and Texas Biomedical Research Institute, wondered if people could be predisposed to diabetes before birth.

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The study involved 18 female baboons that were impregnated by a single fertile male, which avoided complications associated with genes. Once the females reached 30 days of gestation, 12 were randomly assigned to be fed a diet that was appropriate for their weight while the remaining six received 70 percent of the nutrition. Both groups of female baboons continued their assigned diets through delivery and until their offspring were weaned.

Before the offspring reached puberty, the six born to mothers that had followed a restricted diet had increased fasting glucose levels, elevated fasting insulin levels, and other indicators of prediabetes. None of the 12 offspring of female baboons that had been fed a normal diet displayed any of these prediabetes traits.

Nathanielsz pointed out that the level of poor nutrition in this study was comparable to that seen in parts of the United States and in developing countries. Therefore, “poor nutrition at critical periods of development can hinder growth of essential organs such as the pancreas, which sees a significant decrease in its ability to secrete insulin.”

This study was the first to show that inadequate nutrition before birth in primates can damage the pancreas and make offspring susceptible to type 2 diabetes. This early-life susceptibility to insulin resistance may then be joined by other known risk factors for diabetes later in life, including a high-fat Western diet and lack of exercise.

American Diabetes Association
Choi J et al. American Journal of Physiology 2011 Jun; doi: 10.1152/ajpregu.00051.2011