|Type 1 diabetes in children is a condition in which your child's body no longer produces insulin / Photo credit: Robert Przybysz via 123rf|
People are more likely to develop diabetes early in life if they are born earlier than they should be, a new study suggests. Researchers from the Icahn School of Medicine in New York and Clinical Research Centre (CRC) in Sweden hypothesized that preterm birth is associated with increased risks of diabetes into adulthood.
This comes as early births were linked with higher resistance to insulin, although there were no studies that investigated the risks of developing the diseases if a person is born prior to their due date. The results of the study were published in the peer-reviewed medical journal Diabetologia.
Early birth and diabetes
The study involved 4,193,069 Swedish children born from 1973 to 2014 and who were followed until 2015 to determine if they developed either type 1 or type 2 diabetes based on diagnoses and pharmacy data. Type 1 diabetes (TD1) is the less common form of the condition usually emerging in childhood or young adulthood while type 2 (TD2) often occurs in middle-aged and older people.
Analysis of the data found that children up to age 18 and who were born at 37 weeks have a 21% likelihood of developing TD1 compared to those who were born at full term. These children are also 26% more likely to develop TD2 in childhood than those who completed 40 weeks' gestation.
By the time they were 43 years old, the researchers found preemies have a 24% higher risk of TD1 and 49% increased risk of TD2, Reuters reports. It adds that a total of 0.7% of the babies in the study population developed TD1 when they reached middle age while only 0.1% went on to develop TD2.
Casey Crump, the lead author from Icahn School of Medicine, said the disrupted development of the pancreas that comes with preterm birth may contribute to the development of diabetes later in life.
"Parents should know that most children who were born preterm will have good health in childhood and adulthood," Crump told Reuters via email. "However, they also have modestly increased risks of diabetes that persist into adulthood."
A normal pregnancy lasts up to 40 weeks, but infants born after the 37-week mark of gestation are still considered full-term. Those who are born earlier than the mark are considered premature and often have trouble with bodily functions like breathing and digesting food weeks after birth.
Reuters says premature babies are also at risk of other longer-term challenges including impaired vision, hearing, and cognitive skills as well as social and behavioral problems.
A hidden risk factor
Based on the babies' gender, the researchers found that women born preterm are at a higher risk of developing TD2 (60%) than full-term female babies during childhood while preterm males don't have an increased risk.
Female preemies also have a higher risk of TD2 (75%) when they are young adults while their male counterparts only have a 28% increased risk.
"The positive additive interaction indicates that preterm birth accounted for significantly more type 2 diabetes cases among females than males," the researchers said, as per Healio. Healio is a clinical news, information and education website that provides personalized content based on healthcare professionals' needs and areas of interest.
It adds that the study did not find any significant effect on diabetes development among siblings: The researchers included an analysis of siblings, which suggests shared genetic or environmental factors in families only partially explained the increased risk of diabetes in early births compared to its direct effects.
"Specifically, the association between preterm birth and type 2 diabetes in adulthood appeared independent of shared familial factors. Instead, preterm birth and its treatment may have direct effects on [the] later development of diabetes," Crump explained.
The lead author added that the results of their study should influence the assessment of diabetes risk at all stages. He said doctors don't often seek birth histories from adult parents when diagnosing diabetes, making preterm birth a "hidden risk factor."
"Clinicians should now recognize preterm birth as a chronic condition that predisposes to the development of diabetes across the life course...Medical records and history-taking in patients of all ages should routinely include birth history, including gestational age, birth weight, and perinatal complications."
|According to medical experts, type 1 diabetes in children requires consistent care / Photo Credit: Jovan Mandic via 123rf|
Preventing diabetes for preemies
While the study wasn't designed to prevent preterm birth from contributing to risks of diabetes, the results emphasize the importance of preemies taking action in preventing diabetes later in life.
Ciaran Phibbs, a health economist at the VA Palo Alto Health Care System's Health Economics Resource Center, said the environment at home is an important factor to consider especially in TD2. He added that this includes things such as diet and exercise habits that could affect the risk of obesity.
Phibbs, who was not involved in the study, noted that preemies are also at a higher risk of obesity compared to full-term babies.
Crump advised those who were born preterm to prevent their development of diabetes by taking on a healthy lifestyle throughout their life, including adopting a healthy diet, being physically active, and maintaining a normal weight.