Childhood BMI and Fasting Glucose and Insulin Predict Adult Type 2 Diabetes: The International Childhood Cardiovascular Cohort (i3C) Consortium

Abstract

Objective: To examine childhood body mass index (BMI), fasting glucose and insulin in relation to incident adult type-2 diabetes mellitus (T2DM). Research Design and Methods: We used data from The International Childhood Cardiovascular Cohort Consortium. Data included childhood measurements (age 3-19) obtained during the 1970s-90s, a health questionnaire including self-report of adult T2DM (occurrence age, medication use) obtained at mean age 40 years, and a medical diagnosis registry (Finland). Results: The sample included 6,738 participants. Of these, 436 (6.5%) reported onset of T2DM between ages 20-59 (mean 40.8) years, and 86% of them reported use of a confirmed anti-diabetic medication. BMI and glucose (age-and sexstandardized) were associated with incident T2DM after adjustment for cohort, country, sex, race, age and calendar year of measurement. Increasing levels of childhood BMI and glucose were related to incrementally increased risk of T2DM beginning at age 30, beginning at cut points below the 95 th percentile for BMI and below 100 mg/dL for glucose. Insulin was positively associated with adult T2DM after adjustment for BMI and glucose and added to T2DM discrimination. Conclusions: Childhood BMI and glucose are predictors of adult T2DM at levels previously considered to be within the normal range. These easy to apply measurements are appealing from a clinical perspective. Fasting insulin has the potential to be an additional predictor.

Cross-Sectional and Longitudinal Examination of Insulin Sensitivity and Secretion across Puberty among Non-Hispanic Black and White Children

“…More research with a larger sample size is necessary in order to identify clinical predictors for the development of type 2 diabetes during puberty, as it is still a relatively rare disorder. However, findings from the current study and others [ 37 – 39 ] suggest that failure to see improvements in insulin sensitivity in late puberty portends a higher risk of persistent insulin resistance.…”

Poor in-utero growth, and reduced beta cell compensation and high fasting glucose from childhood, are harbingers of glucose intolerance in young Indians

“…The i3C study also hinted at this from a single childhood timepoint and the Early Bird study showed that glucose concentrations track through early childhood into adolescence. 24,28 These results should convince paediatricians to measure glucose concentrations in children, and policy makers to promote preventive measures at a younger age. Measurement of birth length and head circumference in addition to the usual measurement of weight would add to prediction of risk of future diabetes.…”

“…There are few lifecourse studies like ours. 24 Impaired β-cell secretion from an early age was found in both glucose intolerant men and women; men also had diminished insulin sensitivity and thus a ‘double defect’. At 18 years, they had both lower insulin secretion and sensitivity, the latter suggesting either an effect of adolescence and/or glucotoxicity.…”

High rates of diabetes and pre-diabetes in postpartum period in Indian GDM women

“…[13] These women had higher glucose and lower disposition index from childhood and early adolescence (6, 12 years of age) [18] Similarly, diabetes at 40 years of age was predicted by higher childhood glucose in the cohorts in the i3C study. [19] A retrospective search of records of women diagnosed with 'GDM' in the Kaiser Permanente clinic showed higher glucose and lipid abnormalities years before pregnancy.…”