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Premature babies prone to diabetes, NZ study finds
18.11.2004
11.00am - By MARTIN JOHNSTON, health reporter
Babies born very prematurely may be predisposed to developing type 2 diabetes as adults, a study has found.
The study of 50 healthy Auckland children aged 4 to 10, published today in the New England Journal of Medicine - one of the world's leading medical journals - found that sensitivity to the hormone insulin was 40 per cent lower in those born very prematurely.
In New Zealand more than 600 babies a year are born very prematurely - at least eight weeks early. Around 4 per cent of the population are diagnosed with diabetes, and the rate is expected to rise steeply following increasing obesity.
Bodily resistance to insulin, a hormone involved in absorbing blood sugar, is linked to the development of type 2 diabetes, high blood pressure, heart disease and stroke.
The study, by Auckland University's Liggins Institute, compared very-premature children with others born around full-term and of normal weight. The premature babies were either low or normal weight for their age following conception.
Earlier research has linked low birth weight in full-term babies to the development of insulin resistance - up to 35 per cent of type 2 diabetes cases may be attributable to low birth weight - but the institute says the latest study is the first to connect the condition to prematurity.
One of the researchers, paediatric endocrinologist Dr Paul Hofman, said yesterday that the causes of insulin resistance in light, term babies and in all the premature babies studied were unknown.
But it might be poor nutrition at the same age following conception in both cases - in the womb for the first group and outside it for the others.
"We suspect it's either the total amount of calories these children get or more likely the type of calories. We know they get less protein than healthy, term children," he said.
Premature newborns' bodies were unable to process protein in sufficient quantities and they tended to be fed more fat.
Dr Hofman added: "You just can't put any more protein in. There are probably ways of doing that, but because there has been no perceived negative effect of just waiting for a month or two before you start getting [more] protein in, neonatologists have just been waiting till things resolve and then trying to get more calories in as they get a little older.
"But with the sort of data we are seeing it may well be that we need to refocus how we treat neonates, particularly in terms of the sort of food they are getting. That's still a theory, not fact."
Dr Hofman said not all people with insulin resistance developed type 2 diabetes. Sensitivity to insulin could be boosted by healthy habits like eating better, doing enough physical activity and avoiding smoking.
Christchurch Medical School neonatal specialist Professor Brian Darlow said more research was needed on feeding premature babies.
"We want to get these babies to grow as soon as we can, but there are limitations. We don't have protein mixtures to feed intravenously that are ideal for the babies and there are side effects and dangers of giving other sources of calories such as lipids." |
