Women Health Online

A new study published by the American Physiological Society offers the strongest evidence yet that vulnerability to type 2 diabetes can begin in the womb, giving new insight into the mechanisms that underlie a potentially devastating disease at the center of a worldwide epidemic. The study, conducted in baboon primates, finds that when mothers are even moderately undernourished while pregnant and breastfeeding, their offspring are consistently found to be prediabetic before adolescence. It is the first time that diabetes has been shown to have prenatal origins in a primate model.

According to Peter W. Nathanielsz, senior author of the study, “We pass more biological milestones before we are born and in the early weeks of life than at any other time.” Poor maternal nutrition, which translates to less sustenance for growing fetuses, is a stubborn problem in parts of the U.S. and the developing world, Nathanielsz said. Thus, “Poor nutrition at critical periods of development can hinder growth of essential organs such as the pancreas, which sees a significantly decrease in its ability to secrete insulin. Our study is the first to show in a primate that poor nutrition during fetal and early life can damage the pancreas and predispose one to type 2 diabetes.”

The study, “Emergence of insulin resistance in juvenile baboon offspring of mothers exposed to moderate maternal nutrient reduction” was conducted by Nathanielsz and colleagues Jaehyek Choi, Cun Li, and Thomas J. McDonald of the School of Medicine at the University of Texas Health Science Center at San Antonio, and Anthony Comuzzie and Vicki Mattern of the Texas Biomedical Research Institute in San Antonio. The study was funded by the National Institute of Diabetes and Digestive and Kidney Diseases. It is published in the online edition of the American Journal of Physiology—Regulatory, Integrative and Comparative Physiology.

Background

Type 2 diabetes occurs when the body develops resistance to insulin, a hormone that regulates blood sugar. Although the body may initially compensate by secreting more insulin, eventually the pancreas cannot produce enough of the hormone to keep blood sugar from rising. In poorly controlled diabetes, elevated blood sugar severely damages the heart, blood vessels, eyes, kidneys and nerves. The consequences can be fatal and include heart disease, stroke, amputations, blindness and kidney failure.

Worldwide, diabetes is an escalating public health crisis. According to estimates from the World Health Organization (WHO), 366 million people will be diabetic by the 2030, up from 171 million in 2000. This is a 114 percent projected increase.

Formerly called “adult-onset diabetes,” type 2 diabetes is seen increasingly in children at earlier and earlier ages. Excess body weight and physical inactivity are known causes, but Nathanielsz and his collaborators have long been interested in whether some individuals might be predisposed to diabetes from birth, or even earlier. Nathanielsz conducts research on this and similar topics through the Center for Pregnancy and Newborn Research in the UT Health Science Center’s Department of Obstetrics and Gynecology.

The Study

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