Nutrient-mediated teratogenesis and fuel-mediated teratogenesis: two pathways of intrauterine programming of diabetes.
The epidemic of diabetes is spreading quickly to the poor and the deprived. Nutrition during fetal life influences the future risk for diabetes; and both under- and overnutrition contribute and coexist in rapid-transition countries. Nutrient imbalance seems particularly important; for example, low maternal vitamin B(12) status coupled with high folate predicted higher adiposity and insulin resistance in Indian children, suggesting a role for 1-C (methyl) group donors in fetal programming. Maternal hyperglycemia worsens the situation. Improving the early-life environment may be more cost-effective for preventing diabetes than controlling lifestyle factors alone in later life.
Yajnik
Chittaranjan S
CS
Diabetes Unit, King Edward Memorial Hospital, Pune, Maharashtra, India. diabetes@vsnl.com
D000818:Animals; D002648:Child; D003906:Developing Countries; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D047109:Fetal Development; D006801:Humans; D006943:Hyperglycemia / Q000150:complications*; D007194:India / Q000453:epidemiology; D007333:Insulin Resistance; D039382:Maternal Nutritional Physiological Phenomena; D009748:Nutrition Disorders / Q000150:complications*; D011203:Poverty; D011247:Pregnancy; D012307:Risk Factors