A large, new study finds that diabetes, both Type 1 and Type 2, are more likely to develop in individuals who were born prematurely.
Researchers at the Icahn School of Medicine at Mount Sinai in New York came to their conclusion by looking at data from the Swedish Hospital and Outpatient Registries and the Swedish Birth Registry to assess the number of diabetes diagnoses among residents of Sweden born between 1973 and 2014.
They looked at data from 4,193,069 babies for an average of 23 years, some as long as 43 years.
Those born before 39 weeks considered anywhere from extremely preterm (between 22 and 28 weeks) to early term (between 37 and 38 weeks) while those born between 39 and 41 weeks were considered to be born full term.
After analyzing data, they found that individuals born preterm had a 21% greater risk for Type 1 diabetes before age 18 years and a 24% greater risk for Type 1 diabetes in adulthood compared with individuals born at full term.
Also, individuals born preterm had a 26% greater risk for Type 2 diabetes before age 18 years and 49% greater risk for Type 2 diabetes in adulthood compared with individuals born at full term.
They also found that preterm birth accounted for significantly more Type 2 diabetes cases among females than males.
As to why preterm birth is linked to increased risk for diabetes, Dr. Casey Crump, a professor of family medicine at the Icahn School of Medicine at Mount Sinai in New York.
and lead author of the study told dLife there are several potentially relevant mechanisms.
“Preterm birth interrupts normal development of multiple organ systems, including the pancreas, which may potentially reduce the number or function of insulin-producing beta cells,” explains Crump.
He says that preterm birth also alters immune function including T-cell response, which could potentially mediate an association with Type 1 diabetes, consistent with its autoimmune etiology.
Another possibility, according to Crump is that exposure to antenatal corticosteroids and rapid catch-up growth in infancy may also lead to visceral adiposity, insulin resistance, and Type 2 diabetes.
“Iatrogenic factors from intensive care of preterm infants, including suboptimal nutrition and adverse effects of medications or procedures, may further impair glucose metabolism,” he adds.
In addition, the researchers’ analyses of siblings suggested that the associations between preterm birth and either Type 1 or Type 2 diabetes were only partially due to shared genetic or environmental factors in families.
“Instead, preterm birth and its treatment may have direct effects on the later development of both of these outcomes,” he said.
The authors conclude that doctors should recognize preterm birth as a condition that may predispose individuals to develop diabetes.
Further, they add medical records and history-taking in patients should include birth history, including gestational age, birth weight, and perinatal complications. Such information could aide in early preventive measures.
The findings are published in Diabetologia.
- Crump C, et al. Diabetologia. Preterm birth and risk of type 1 and type 2 diabetes: a national cohort study. Retrieved December 6, 2019, from https://link.springer.com/article/10.1007%2Fs00125-019-05044-z