Susceptibility to diabetes revealed as early as eight years of age: Study

Diabetes doesn't develop overnight.It develops for many years before diagnosis.

Researchers have found in a new study that early signs of being more susceptible to type 2 diabetes as an adult can be seen in children as young as 8 years old, decades before it is likely to be diagnosed.The new study has been published in Diabetes Care .

The researchers conducted a study to reveal early metabolic features characterizing liability to adult disease by examining genetic liability to adult type 2 diabetes in relation to metabolomic traits across early life.

The research looked at the effects of a genetic risk score for developing type 2 diabetes as an adult on metabolism measured from blood samples taken from the participants in the study when they were aged 8, 16, 18, and 25 years.

One of the earliest metabolic features of type 2 diabetes liability is lower lipid content in HDL particles—particularly in very large and large subtypes—alongside lower citrate and higher BCAA and inflammatory glycoprotein acetyl levels.

The study tracked over 4,000 participants in the Children of the 90s - a health study established at the University of Bristol in the early 1990s. Researchers combined genetic information with an approach called 'metabolomics', which involves measuring many small molecules in a blood sample, to try and identify patterns that are specific to early stages of type 2 diabetes development.

One of the leading investigators Dr Joshua Bell explained: "We knew that diabetes doesn't develop overnight. What we didn't know is how early in life the first signs of disease activity become visible and what these early signs look like. We addressed these by looking at the effects of being more genetically prone to type 2 diabetes in adulthood on measures of metabolism taken across early life. This would not have been possible without the Children of the 90s study.

"Diabetes is most common in older age, but we see signs of disease susceptibility very early on - about 50 years before it's usually diagnosed. Knowing what these early signs look like widens our window of opportunity to intervene much earlier and stop diabetes before it becomes harmful."

The study was conducted among young people who were generally free of type 2 diabetes and other chronic diseases to see how early in life the effects of being more susceptible to adult diabetes become visible. In particular, certain types of HDL cholesterol were reduced at age 8 before other types of cholesterol including LDL were raised; inflammation and amino acids were also elevated by 16 and 18 years old. These differences widened over time.

Dr Bell continued: "We're talking about the effects of susceptibility rather than of clinical disease itself. This does not mean that young people 'already have adult diabetes'; these are subtle differences in the metabolism of young people who are more prone to developing it later in life.

"These findings help reveal the biology of how diabetes unfolds and what features may be targetable much earlier on to prevent the onset of disease and its complications. This is important because we know that the harmful effects of blood glucose, such as on heart disease, are not exclusive to people with diagnosed diabetes but extend to a smaller degree to much of the population."

For further reference log on to:

Diabetes Care 2020 Jul; 43(7): 1537-1545.

https://doi.org/10.2337/dc19-2348