Lower-Weight Babies At Greater Risk For Diabetes Later In Life

A person's lifetime risk of developing diabetes decreased for each 2.2 pounds he or she weighed over lower-weight babies, study author Donald Yarbrough said.  The report didn't examine the risk that babies born at the heaviest weights, 8.8 pounds or more, faced for adult diabetes, Yarbrough said.

About 23.6 million Americans, or 7.8 percent of the U.S. population, have diabetes, according to the National Institutes of Health. More studies are needed to determine why those born at lower weights have a higher risk of the disease, Yarbrough said.

"Birth weight is a crude marker for something that's going on," Yarbrough, medical director of bariatric surgery at Sacred Heart Medical Center in Springfield, Ore., said in a  interview last week. "The early interuterine environment plays a crucial role in proper development of the organs, which can lead to chronic disease many years later in life."

Type 2 diabetes, which in adults is linked to obesity, lack of exercise and older age, accounts for as much as 95 percent of diabetes cases in the United States. Those with the condition don't produce enough insulin, or their cells ignore the insulin. Insulin is needed for the body to use sugar for energy.

Other risk factors for developing the disease include having a family member with diabetes, gestational diabetes during pregnancy, high blood pressure and a history of heart disease, according to the National Institutes of Health.

The review looked at 30 studies with a combined total of 152,084 people, of whom 6,090 had diabetes. The studies were conducted in Europe, North America, India, China and Japan. They found that the lifetime risk of developing diabetes dropped about 20 percent to 25 percent for each increase of 2.2 pounds a baby weighed at birth, Yarbrough said. They excluded babies weighing 8.8 pounds or more. ]

Researchers are unsure why babies born at lower birth weights have a higher risk of diabetes, but they speculate that changes to the structure of the pancreas and hormone levels before these babies are born may play a role, Yarbrough said.
"The study should raise awareness of the importance of maternal nutrition," he said. "We need to strive to have healthy-weight babies."
JAMA, Vol. 300 No. 24, December 24/31, 2008