Evidence for Decreasing Prevalence of Diabetes Mellitus in Childhood Apparently Produced by Prevention of Hyperinsulinism in the Foetus and Newborn

Abstract

In view of experimental and clinical findings, it was predicted (Dörner, 1973 and 1976; Dörner and Mohnike, 1973 and 1977) that a preventive therapy of diabetes mellitus may be possible by preventing hyperinsulinism in perinatal life by means of prevention of hyperglycaemia in pregnant women and overnutrition in newborns. Meanwhile, this prediction appears to have been realized. Thus, the prevalences of diabetes mellitus in children, who were born in Berlin/GDR over the past decade, were found to be significantly decreased as compared to those born between 1962 and 1972. On the other hand, the children born in Berlin/GDR between 1962 and 1972 displayed a significantly higher prevalence of diabetes mellitus as compared to those born between 1957 and 1961. The decreasing prevalence of childhood-onset diabetes over the past decade has been apparently achieved by systematic prevention of hyperglycaemia and impaired glucose tolerance in pregnant women and overnutrition in newborns. These findings suggest that a preventive therapy of diabetes mellitus--even of insulin-dependent childhood-onset diabetes--is possible by preventing hyperinsulinism in the foetus and newborn during differentiation and maturation of the neuroendocrine central nervous-pancreatic system.

Fetal growth and developmental programming

“…D ö rner was among the fi rst to provide evidence that exposure to a diabetic intra-uterine environment increases the risk of developing diabetes in the offspring. Moreover, he showed a transgenerational effect and the importance of good metabolic control in the prevention of long-term consequences [17,18] . These observations were confi rmed by several epidemiologic studies and recently summarized: the excess of maternal transmission of diabetes is consistent with an epigenetic effect of hyperglycemia in pregnancy acting in addition to genetic factors that induce diabetes in next generations.…”

Rat maternal diabetes impairs pancreatic β-cell function in the offspring

“…Intrauterine exposure to hyperglycemia is also associated with a higher prevalence of impaired glucose tolerance in adolescence (44) and with an excess of obesity, especially during the first 20 yr of life (10,40,41,45). Systematic prevention of hyperglycemia and impaired glucose tolerance in pregnant women have significantly decreased the prevalence of diabetes mellitus in their children (12). Studies of Pima Indians provide further indication for a role of maternal diabetes in utero: NIDDM is present by age 20 -24 yr in 45.5% of the offspring of diabetic mothers but only in 8.6% and 1.4% of respective offspring of prediabetic or nondiabetic mothers (39).…”

The secret language of destiny: stress imprinting and transgenerational origins of disease

“…The concept that vulnerability to disease is acquired in the perinatal period was developed more than 30 years ago (e.g., Dörner et al, 1984). Studies by David Barker’s group in the 1990s have first associated adverse perinatal environment with higher incidence of obesity and cardiovascular disease in the aged offspring (Law et al, 1992; Barker, 2007).…”