Low-birth-weight infants show earlier onset of IDDM.

Abstract

OBJECTIVE--Pancreatic beta-cell mass increases rapidly during gestation and early infancy. Infants who are small for gestational age, which is a marker for poor intrauterine nutrition, have reduced beta-cell mass. We examined whether weight and length in early infancy, and in inference beta-cell mass, is related to age at onset of insulin-dependent diabetes mellitus (IDDM). RESEARCH DESIGN AND METHODS--Data from infant records of 232 patients with IDDM, including birth weight, birth length, gestational age, weight at 6 months of age, and feeding history during the first 6 months of life, were analyzed. Maternal recall was not used for data collection. RESULTS--Low-birth-weight infants (<2.5 kg) showed a significantly earlier onset of diabetes (4.3 [3.2-6.0] years vs. 9.0 [5.3-11.8] years, median [25-75th percentile]; P < 0.0001). Infants small for gestational age also had earlier onset than those with birth weight above the 10th percentile after correction for gestational age (6.2 [3.6-10.5] vs. 9.2 [5.4-11.8] years; P < 0.0001). Infants with corrected birth weight: length ratio below the 10th percentile had earlier onset, as did infants with corrected 6-months weight below the 10th percentile (4.9 [2.8-6.0] years vs. 8.8 [5.2-11.8] years; P < 0.0001). Infants who were exclusively breast-fed for 6 months showed a slightly later onset of diabetes than those who were bottle- or mixed-fed, independent of weight (9.4 [5.0-11.3] years vs. 8.3 [4.2-11.7] years; P < 0.0001). CONCLUSIONS--Weight and growth parameters in utero and early infancy may influence the age at onset of IDDM. beta-cell mass is likely to be a significant factor.