December 29, 2014
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Elevated fasting insulin concentrations in early childhood linked to type 2 diabetes later

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An elevated risk of type 2 diabetes in adulthood is found with elevated fasting insulin concentrations in early childhood, but not in adolescence, according to recent study findings published in Pediatrics.

Matthew A. Sabin, MD, PhD, of Royal Children’s Hospital and the University of Melbourne in Australia, and colleagues evaluated 2,478 children and adolescents from the Cardiovascular Risk in Young Finns Study aged 3 to 18 years at baseline (1980) to determine the effect of childhood fasting insulin concentrations on the risk for developing type 2 diabetes in adulthood. Follow-up was between 21 and 31 years when participants were aged 24 to 49 years. Overall, 84 cases of type 2 diabetes in adulthood were found.

Type 2 diabetes in adult life was significantly linked to fasting insulin values in young children aged 3 to 6 years even after adjustment for age, gender, duration of follow-up, child BMI and parental history of type 2 diabetes. When adjusted for child BMI, no association was found between fasting insulin levels and later type 2 diabetes in children and adolescents aged 9 to 18 years. However, a significant association was observed when adjusted for gender, age and duration of follow-up.

There was a significant association between type 2 diabetes in adult life and BMI in later childhood and adolescence, even following adjustment for age, gender, duration of follow-up, child insulin level and parental history of type 2 diabetes. However, no association was found between BMI and type 2 diabetes in adult life for younger children.

Normal BMI and insulin value in childhood was found among 61 participants who developed type 2 diabetes in adult life. Those who developed type 2 diabetes in adult life also had higher mean levels of fasting insulin (P<.001) and BMI (P<.001).

“In conclusion, we report that elevated fasting insulin concentrations in young children may be useful in determining who is at greatest risk of developing [type 2 diabetes] in adult life,” the researchers wrote. “However, in older children and adolescents there was no clear association between insulin levels and later [type 2 diabetes]; instead, associations were seen with BMI. Taken together, these data suggest that caution is warranted in interpreting elevated fasting insulin levels in older childhood and adolescence as an indicator of risk for the development of later [type 2 diabetes].”

Disclosure: See the full study for a complete list of the researchers’ relevant financial disclosures.