Global estimates suggest that more than 70,000 children are diagnosed with type I diabetes annually. The incidence of type I diabetes among youths has increased significantly , and concerningly, this annual incidence rate is occurring almost all around the globe. Whilst genetics only explain 30–40 % of the total susceptibility for type I diabetes, gestational and early life risk factors have long been proposed as additional major contributors, putatively mediated by nutrient transfer in utero and their subsequent effect on foetal development of the pancreas. Although several large studies have been conducted in this area, it still remains controversial, with both high and low birthweights being independently implicated. Despite previous meta-analyses reporting positive associations between high birthweight and type I diabetes in overall pooled estimates, this finding has not been consistently demonstrated in all previously reviewed or in subsequent, empirical investigations.

Whereas some studies have concluded that high birthweight is associated with an increased or reduced type I diabetes risk, others have reported no association at all. The association between increased prenatal weight gain and risk of type I diabetes appears to be extended into early infancy, as it has been demonstrated that rapid weight gain during the first year of life increases the risk of type I diabetes in the child. On the contrary, it has been proposed that low birth weight, which is considered to be a risk factor for type II diabetes, is also associated with an increased risk of type I diabetes. Since the publication of the most recent meta-analyses on the topic, nearly a decade ago, numerous recent studies consisting of extremely large sample sizes and empirical data have emerged, with conclusions far from reaching consensus. Given the potential health implications associated with high and low birth weight, respectively, and injurious associations with maternal pre-pregnancy body-mass index (BMI) and childhood type I diabetes, it would be pragmatic to assimilate and analyse all the current available evidence to better inform clinicians, the public and all other key stakeholders. Thus, the aim of this systematic review and meta-analysis was to examine the dose-response relationship between pre-pregnancy BMI, birth weight and childhood type I diabetes in cohort studies.

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Mishita
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Journal of  Autoimmune Disorders