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Early determinants of type-2 diabetes
1University of Cambridge Metabolic Research Laboratories, Institute of Metabolic Science, Addenbrooke's Hospital, Cambridge, United Kingdom.
Best Practice & Research. Clinical Endocrinology & Metabolism
|September 18, 2012
Summary
Early life environments, including maternal health and birth weight, significantly influence type-2 diabetes (T2D) risk. Understanding these programming mechanisms is crucial for preventing T2D across generations.
Area of Science:
- Endocrinology and Metabolism
- Developmental Biology
- Public Health
Background:
- Global type-2 diabetes (T2D) prevalence has doubled in 30 years, imposing significant health and financial burdens.
- T2D aetiology is multifactorial, involving genetic, epigenetic, and environmental factors, with diet and lifestyle being key.
- Increasing early-onset T2D and pre-diabetic characteristics in children highlight the critical role of the early life environment.
Purpose of the Study:
- To review evidence on how the early life environment programs T2D risk.
- To explore potential mechanisms underlying this programming.
- To inform the development of interventions to prevent or mitigate T2D risk.
Main Methods:
- Review of human and animal studies focusing on early life exposures and T2D risk.
- Analysis of historical and recent research on factors like birth weight, maternal obesity, and maternal diabetes.
- Examination of evidence for paternal and transgenerational T2D transmission.
Main Results:
- Low birthweight, as a proxy for in utero growth, is associated with adult T2D risk.
- Maternal obesity and diabetes during pregnancy significantly impact offspring health outcomes.
- Paternal and transgenerational factors contribute to a cyclical transmission of T2D risk.
Conclusions:
- The early life environment plays a critical role in programming an individual's susceptibility to T2D.
- Elucidating the mechanisms of T2D programming is essential for developing effective interventions.
- Interventions targeting pre- and postnatal factors may prevent, delay, or reverse T2D risk, improving long-term health outcomes.
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