Type 2 Diabetes Mellitus in Children: Prenatal and Early Infancy Risk Factors Among Native Canadians
Abstract
BACKGROUND: Type 2 diabetes mellitus is increasingly being observed among children and youth, including the Native population of Canada. Only one study has investigated prenatal and early infancy risk factors for the disease. METHODS: A case-control study was conducted; 46 patients younger than 18 years were recruited from the only clinical center for the treatment of diabetes serving the province of Manitoba, and 92 age- and sex-matched controls were recruited from a pediatric ambulatory clinic serving a large Native population in Winnipeg, Manitoba. Information on exposure to prenatal and early infancy risk factors was obtained through questionnaires administered by a Native nurse-interviewer. RESULTS: Multiple logistic regression modeling identified preexisting diabetes (odds ratio [OR], 14.4; 95% confidence interval [CI], 2.86-72.5), gestational diabetes (OR, 4.40; 95% CI, 1.38-14.1), and breastfeeding longer than 12 months (OR, 0.24; 95% CI, 0.13-0.99) as significant independent predictors of diabetic status. Other factors, such as low (<2500 g) and high (>4000 g) birth weight and maternal obesity, were also associated with diabetes in our population, but the elevated risks were not statistically significant. CONCLUSION: Breastfeeding reduces the risk of type 2 diabetes among Native Canadian children and should be promoted as a potential intervention to control the disease.
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The increased risk of infants born to women with diabetes for childhood obesity and later development of impaired glucose intolerance and diabetes is reduced by breastfeeding.
“The increased risk of infants born to women with diabetes for childhood obesity and the later development of impaired glucose intolerance and diabetes (81) is reduced by breastfeeding (202–211).”
From Diabetes and Pregnancy: An Endocrine Society Clinical Practice Guideline (2013) · cites this paper as [210]
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“The Pima study shows that in families where children were born both before and after their mother was diagnosed with diabetes, the risk of diabetes was almost 4-fold higher among siblings born after the mother developed diabetes.(24) About 40% of type 2 diabetes cases among 5- to 19year-old Pima children can be attrib…”
BackgroundBreastfeeding and incidence of non-insulin-dependent diabetes mellitus in Pima Indians
Pettitt, D. J., Forman, M. R., Hanson, R. L., Knowler, W. C., & Bennett, P. H. (1997) · The Lancet · doi:10.1016/s0140-6736(96)12103-6 · Cited by 357 · see citing works
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Obesity in children and young people: a crisis in public health
Lobstein, T., Baur, L., & Uauy, R. (2004) · Obesity Reviews · doi:10.1111/j.1467-789x.2004.00133.x · Cited by 3,801 · see citing works
Early Developmental Conditioning of Later Health and Disease: Physiology or Pathophysiology?
Hanson, M. A., & Gluckman, P. D. (2014) · Physiological Reviews · doi:10.1152/physrev.00029.2013 · Cited by 1,188 · see citing works
Diabetes and Pregnancy: An Endocrine Society Clinical Practice Guideline
Blumer, I., Hadar, E., Hadden, D. R., Jovanovič, L., Mestman, J. H., Murad, M. H., & Yogev, Y. (2013) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2013-2465 · Cited by 561 · see citing works
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Diet, nutrition and the prevention of type 2 diabetes
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Wicklow, B. A., Sellers, E. A. C., Sharma, A. K., Kroeker, K., Nickel, N. C., Philips-Beck, W., & Shen, G. X. (2018) · JAMA Pediatrics · doi:10.1001/jamapediatrics.2018.1201 · Cited by 88 · see citing works
Self-citationBreastfeeding After Gestational Diabetes Pregnancy
Gunderson, E. P. (2007) · Diabetes Care · doi:10.2337/dc07-s210 · Cited by 71 · see citing works
Phillips-Beck, W., Sinclair, S., Campbell, R., Star, L., Cidro, J., Wicklow, B., Guillemette, L., Morris, M. I., & McGavock, J. M. (2019) · Journal of Developmental Origins of Health and Disease · doi:10.1017/s2040174418000661 · Cited by 44 · see citing works
- Authors
- Young, T. K., Martens, P. J., Taback, S. P., Sellers, E. A. C., Dean, H. J., Cheang, M., & Flett, B.
- Affiliations
- University of Manitoba (CA)
- Venue
- Archives of Pediatrics & Adolescent Medicine
- Publisher
- American Medical Association (AMA)
- Published
- 2002-07-01
- Volume
- 156
- Issue
- 7
- Pages
- 651
- ISSN
- 1072-4710 (ISSN-L)
- OpenAlex
- W2103254931
- Cited by
- 227
- References
- 2
- Citations by year
- 2026: 2 · 2025: 5 · 2024: 3 · 2023: 1 · 2022: 8 · 2021: 6 · 2020: 3 · 2019: 7 · 2018: 11 · 2017: 6 · 2016: 9 · 2015: 6 · 2014: 15 · 2013: 15 · 2012: 14
- FWCI
- 9.09
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Archives of Pediatrics and Adolescent Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Birth, Development, and Health
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Diabetes and associated disorders
- Health Sciences › Medicine › Obstetrics and Gynecology › Gestational Diabetes Research and Management
- Keywords
- type 2 diabetes, pediatric diabetes, breastfeeding, gestational diabetes mellitus, prenatal risk factors, birth weight, maternal obesity, pregestational diabetes, diabetes risk factors
- MeSH terms
- Adolescent, Breast Feeding, Child, Child Development, Child, Preschool, Diabetes Mellitus, Type 2, Female, Health Promotion, Humans, Indians, North American, Infant, Infant, Newborn, Male, Manitoba, Maternal Behavior, Pregnancy, Pregnancy Complications, Prenatal Care, Surveys and Questionnaires, Risk Factors, Logistic Models, Odds Ratio, Case-Control Studies
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