Type 2 Diabetes Detectable Decades Before Onset
Study finds that people destined to develop diabetes as adults show signs of beta cell dysfunction as early as five years of age
The EarlyBird Study, a nonintervention cohort study that followed 300 healthy UK children from age 5 to 16 years, continues to deliver valuable information on the progression and cause of type 2 diabetes.
A new analysis of this data has revealed that signs of insulin secretion and blood glucose abnormalities are detectable in children at risk for developing adult-onset diabetes at ages as young as five.
These risk indicators are present well before significant weight gain and puberty occurs and may provide an effective way to identify at-risk individuals early on in childhood.
The First Signs of Diabetes
According to the study, which was published in Diabetes Care, signs of beta cell defects early on in childhood is a significant predictor of pre-diabetes onset later in life.
Impaired fasting glycemic levels were detectable in children by the age of 15 and corresponded with instances of high blood sugar detectable at the age of 5.
Most importantly, genetic analysis of the at-risk and low-risk children found that those destined to develop diabetes showed the same single nucleotide polymorphisms that are associated with type 2 in adults.
These genetic pathways proved influential to glycemic values and insulin traits in youth before drastic changes to BMI and before puberty began.
These findings prove that beta cell dysfunction is influenced by genes independent of weight and is apparent before insulin resistance and weight gain occurs.
Genetic Markers and Diabetes Risk
Many common genetic variants found in the population were associated with high fasting glucose levels.
One genetic variant, in particular, known as ZBED3, has long been associated with type 2 diabetes. In this study, it was strongly associated with elevated blood sugars throughout childhood. It is believed this variant reduces fiber intake and that a fiber-heavy diet may reduce diabetes risk in children with the ZBED3 variant.
The GCKR variant, on the other hand, has long been associated with lower fasting blood glucose levels. This pattern held true in youth with the GCKR variant before and after puberty.
The fact that so many variants associated with type 2 in adults showed a marked influence on blood glucose levels in children indicates that early intervention may prevent the progression or appearance of the disease in adulthood.
Effective Early Identification of At-Risk Individuals
Despite a growing number of children being diagnosed with type 2 diabetes, this disease is most often diagnosed in adulthood. However, this study clearly indicates that the roots of the disease are present early-on in childhood.
This presents a unique opportunity for introducing anti-diabetes therapies decades before the disease actually presents itself. Such an early intervention is likely to be more successful in preventing type 2 than waiting to initiate the same therapies during the pre-diabetic phase or even shortly after puberty.
The study of specific genetic variants and the pathways by which they influence elevated blood sugars early in life also allows researchers the ability to develop very specific treatments for each individual child.
Since there appears to be a wide array of pathways by which beta-cell function is reduced and insulin resistance propagated, this kind of individualized therapy is much more likely to be successful in preventing type 2 diabetes than a one-size-fits-all approach.