title: Developmental origins of type 2 diabetes: a perspective from China.
abstract: There has been a marked increase in the prevalence of diabetes in Asia, including China, over the last few decades. While the increased prevalence of diabetes has often been attributed to the nutritional transition associated with recent economic development, emerging data suggest that early-life exposures also play a major role in shaping developmental trajectories, and contributes to alter an individual's susceptibility to diabetes and other non-communicable diseases (NCDs). Early-life exposures such as in utero exposure to undernutrition has been consistently linked with later risk of diabetes and obesity. Furthermore, in utero exposure to maternal hyperglycemia, maternal obesity and excess gestational weight gain are all linked with increased childhood obesity and later risk of diabetes. Emerging data have also highlighted the potential link between early-feeding practices, the role of one-carbon metabolism in metabolic programming and endocrine disrupting chemicals (EDCs) with later risk of diabetes. These different developmental exposures may all be highly relevant to the current epidemic of diabetes in China. For example, the prevalence of gestational diabetes has increased markedly over the last two decades, and may contribute to the diabetes epidemic by driving macrosomia, childhood obesity and later risk of diabetes. In order to address the current burden of diabetes, a lifecourse perspective, incorporating multisectoral efforts from public health policy down to the individuals, will be needed. Several major initiatives have been launched in China as part of its national plans for NCD prevention and treatment, and the experience from these efforts would be invaluable.
authors.affiliation: Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China.|Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Hong Kong, China.|Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Hong Kong, China.|NHMRC Clinical Trials Centre, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia.
authors.forename: R C W
authors.initials: RCW
authors.lastname: Ma
authors.affiliation: Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China.
authors.forename: K Y
authors.initials: KY
authors.lastname: Tsoi
authors.affiliation: Department of Obstetrics and Gynaecology, The Chinese University of Hong Kong, Hong Kong, China.
authors.forename: W H
authors.initials: WH
authors.lastname: Tam
authors.affiliation: Department of Biology, Croucher Institute for Environmental Sciences, Hong Kong Baptist University, Hong Kong, China.
authors.forename: C K C
authors.initials: CKC
authors.lastname: Wong
mesh_terms: D002681:China / Q000453:epidemiology; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology*; D016640:Diabetes, Gestational / Q000453:epidemiology*; D004032:Diet; D005260:Female; D015438:Health Behavior; D006291:Health Policy; D006801:Humans; D008019:Life Style; D044342:Malnutrition / Q000453:epidemiology*; D039382:Maternal Nutritional Physiological Phenomena; D015201:Meta-Analysis as Topic; D009765:Obesity / Q000453:epidemiology*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology*; D011297:Prenatal Exposure Delayed Effects; D015995:Prevalence; D011634:Public Health; D012307:Risk Factors