![[Feedback]](/icons/banner/feedbackACT.gif){kind=icon}
![[For Subscribers]](/icons/banner/subscriberACT.gif){kind=icon}
![[Archive]](/icons/banner/archiveACT.gif){kind=icon}
![[Search]](/icons/banner/searchACT.gif){kind=icon}
![[Contents]](/icons/banner/tocACT.gif){kind=icon}
|
|
|
|
|
||
Diabetes Unit, King Edward Memorial Hospital and Research Center, Rasta Peth, Pune 411011, India
2To whom correspondence should be addressed. E-mail: diabetes{at}vsnl.com.
There is a rapidly increasing epidemic of type 2 diabetes in India and other Asian countries. The thrifty genotype and the thrifty phenotype are two nonexclusive explanations. People in the Indian subcontinent have faced undernutrition for many generations, and Indian babies are among the smallest in the world. However, the diabetes epidemic is of recent origin, and diabetes is more common among urban than rural Indians despite the higher birth weight of urban babies. This suggests that postnatal factors must also contribute. Thus, a life-course model of evolution of insulin resistance and type 2 diabetes, incorporating fetal, postnatal and adult components, seems most appropriate. For a given BMI, Indians have a higher percentage of body fat and more visceral fat than members of other populations. This thin-fat phenotype is present at birth. Neonatal size and body composition are influenced by parental size, maternal food intake, physical activity and circulating concentrations of nutrients and metabolites (folate, glucose, triglycerides, cholesterol etc.). Maternal insulin resistance promotes transfer of nutrients to the fetus. Accelerated childhood growth is another risk factor for adiposity and insulin resistance, especially in children born small. Childhood growth seems to be more influenced by paternal genetic factors, whereas intrauterine growth is more influenced by maternal factors (intrauterine environment). Urban lifestyles, including poor diet and sedentary habits, promote further obesity, insulin resistance and type 2 diabetes. These factors may be amenable to correction. Prevention of type 2 diabetes must begin in utero and continue throughout the life course.
KEY WORDS: • type 2 diabetes • birth weight • fetal programming • Asians
This article has been cited by other articles:
|
|
 |
|
  C. Sauvaget, K. Ramadas, G. Thomas, J. Vinoda, S. Thara, and R. Sankaranarayanan Body mass index, weight change and mortality risk in a prospective study in India Int. J. Epidemiol., October 1, 2008; 37(5): 990 - 1004. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R Ramaraj and P Chellappa Cardiovascular risk in South Asians Postgrad. Med. J., October 1, 2008; 84(996): 518 - 523. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L. Ibanez, A. Lopez-Bermejo, L. Suarez, M. V. Marcos, M. Diaz, and F. de Zegher Visceral Adiposity without Overweight in Children Born Small for Gestational Age J. Clin. Endocrinol. Metab., June 1, 2008; 93(6): 2079 - 2083. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. Balagopal, N. Kamalamma, T. G. Patel, and R. Misra A Community-Based Diabetes Prevention and Management Education Program in a Rural Village in India Diabetes Care, June 1, 2008; 31(6): 1097 - 1104. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. Ibanez, L. Suarez, A. Lopez-Bermejo, M. Diaz, C. Valls, and F. de Zegher Early Development of Visceral Fat Excess after Spontaneous Catch-Up Growth in Children with Low Birth Weight J. Clin. Endocrinol. Metab., March 1, 2008; 93(3): 925 - 928. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. W. J. Leunissen, P. Oosterbeek, L. K. M. Hol, A. A. Hellingman, T. Stijnen, and A. C. S. Hokken-Koelega Fat Mass Accumulation during Childhood Determines Insulin Sensitivity in Early Adulthood J. Clin. Endocrinol. Metab., February 1, 2008; 93(2): 445 - 451. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. Khanam and V. Costarelli Attitudes towards health and exercise of overweight women The Journal of the Royal Society for the Promotion of Health, January 1, 2008; 128(1): 26 - 30. [Abstract] [PDF]
|
|
|
|
 |
|
 L. M. Candib Obesity and Diabetes in Vulnerable Populations: Reflection on Proximal and Distal Causes Ann. Fam. Med, November 1, 2007; 5(6): 547 - 556. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E. S. Buhl, S. Neschen, S. Yonemitsu, J. Rossbacher, D. Zhang, K. Morino, A. Flyvbjerg, P. Perret, V. Samuel, J. Kim, et al. Increased hypothalamic-pituitary-adrenal axis activity and hepatic insulin resistance in low-birth-weight rats Am J Physiol Endocrinol Metab, November 1, 2007; 293(5): E1451 - E1458. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. R. Kulkarni, C. H.D. Fall, N. V. Joshi, H. G. Lubree, V. U. Deshpande, R. V. Pasarkar, D. S. Bhat, S. S. Naik, and C. S. Yajnik Determinants of Incident Hyperglycemia 6 Years After Delivery in Young Rural Indian Mothers: The Pune Maternal Nutrition Study (PMNS) Diabetes Care, October 1, 2007; 30(10): 2542 - 2547. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Malamitsi-Puchner, D. D. Briana, M. Boutsikou, E. Kouskouni, D. Hassiakos, and D. Gourgiotis Perinatal Circulating Visfatin Levels in Intrauterine Growth Restriction Pediatrics, June 1, 2007; 119(6): e1314 - e1318. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G. Caire-Juvera, M. I. Ortega, E. Casanueva, A. V. Bolanos, and A. M. C. de la Barca Food Components and Dietary Patterns of Two Different Groups of Mexican Lactating Women J. Am. Coll. Nutr., April 1, 2007; 26(2): 156 - 162. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. A Lawlor and N. Chaturvedi Treatment and prevention of obesity--are there critical periods for intervention? Int. J. Epidemiol., February 1, 2006; 35(1): 3 - 9. [Full Text] [PDF]
|
|
|
|
 |
|
 C. A Maloney and W. D Rees Gene-nutrient interactions during fetal development Reproduction, October 1, 2005; 130(4): 401 - 410. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Ehtisham, N. Crabtree, P. Clark, N. Shaw, and T. Barrett Ethnic Differences in Insulin Resistance and Body Composition in United Kingdom Adolescents J. Clin. Endocrinol. Metab., July 1, 2005; 90(7): 3963 - 3969. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Thamotharan, B.-C. Shin, D. T. Suddirikku, S. Thamotharan, M. Garg, and S. U. Devaskar GLUT4 expression and subcellular localization in the intrauterine growth-restricted adult rat female offspring Am J Physiol Endocrinol Metab, May 1, 2005; 288(5): E935 - E947. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A M Prentice and S E Moore Early programming of adult diseases in resource poor countries Arch. Dis. Child., April 1, 2005; 90(4): 429 - 432. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. Schwartz and J. L. Morrison Impact and mechanisms of fetal physiological programming Am J Physiol Regulatory Integrative Comp Physiol, January 1, 2005; 288(1): R11 - R15. [Full Text] [PDF]
|
|
|
|
 |
|
 S. Boullu-Ciocca, A. Dutour, V. Guillaume, V. Achard, C. Oliver, and M. Grino Postnatal Diet-Induced Obesity in Rats Upregulates Systemic and Adipose Tissue Glucocorticoid Metabolism During Development and in Adulthood: Its Relationship With the Metabolic Syndrome Diabetes, January 1, 2005; 54(1): 197 - 203. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. L. Kind, C. T. Roberts, A. I. Sohlstrom, A. Katsman, P. M. Clifton, J. S. Robinson, and J. A. Owens Chronic maternal feed restriction impairs growth but increases adiposity of the fetal guinea pig Am J Physiol Regulatory Integrative Comp Physiol, January 1, 2005; 288(1): R119 - R126. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. G. Bouret and R. B. Simerly Minireview: Leptin and Development of Hypothalamic Feeding Circuits Endocrinology, June 1, 2004; 145(6): 2621 - 2626. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L. S. Adair and A. M. Prentice A Critical Evaluation of the Fetal Origins Hypothesis and Its Implications for Developing Countries J. Nutr., January 1, 2004; 134(1): 191 - 193. [Full Text] [PDF]
|
|
