If you could learn what diseases you’re going to develop later in life, would you?

Your birth weight tells a story about you and your future. In particular, it reveals what diseases you are at risk of developing during adulthood. Screening for diseases based on your birth weight may one day become a reality and my research project may help to pave the way towards that! My name is Noushin and I am an MSci Biochemistry student from the University of Surrey. My research project investigates if low birthweight increases the risk for developing type 2 diabetes during adulthood.

I don’t know how much you know about type 2 diabetes, but since my father was diagnosed in 2006, I’ve learnt a lot. Watching the decline of his mental and physical health has been a devastating experience and it makes me question if I am destined to share the same fate. “Will I be affected too? What about my future children?” are questions I commonly ask myself. That is why I chose this project, because I want to raise awareness about the condition and make my scientific contribution to the diabetes community. 

Imagine you are growing a garden. Nurturing your garden with high-quality soil and sufficient nutrients and water are all important for your garden to flourish and grow. If you do not feed your plants enough, your plants cannot adequately grow and will be smaller and less healthy. Just like plants, fetuses determine their growth patterns based on the status of their environment. If the mother isn’t eating a sufficient amount of food, the fetus will not receive enough glucose from the mother. Glucose is a sugar obtained from the food the mother eats and it is the fetus’ main source of energy, so the fetus will not have the energy required to adequately grow. The fetus will be born small with a low birthweight and has a higher risk of developing type 2 diabetes during adulthood. This concept is known as the fetal origins hypothesis, and if it is correct, then it means that the seeds of type 2 diabetes risk have been sown before we are even born…

You might be thinking by now, “what actually is type 2 diabetes?”. Normally after a meal, your body breaks food down into glucose which travels in the blood. Glucose wants to leave the blood and enter cells because that is how the body receives energy, so the pancreas takes action and produces insulin, a hormone which helps move glucose into cells. In a diabetic patient like my father, the insulin may be sitting with the glucose, knocking on the door of the cell saying, “let us in!”, but the cell ignores insulin and the door stays shut, so glucose is trapped in the blood. This is known as insulin resistance. The pancreas panics and tries to fix the situation by producing more insulin to get rid of the excess glucose… but the door still stays shut. Eventually, the pancreas gets so exhausted that it ends up producing less insulin, causing the levels of glucose in the blood to skyrocket.  As the fetal origins hypothesis suggests, having a low birthweight is also associated with a higher risk of type 2 diabetes, but we all know that correlation does not necessarily equal causation. My project, therefore, will test and prove that there is a causal relationship using statistics. 

Figure 1. Schematic diagram illustrating how low birthweight potentially increases the risk of developing type 2 diabetes during adulthood. Maternal malnutrition causes fetal malnutrition which leads to decreased fetal growth, characterised by low birthweight. This leads to insulin resistance and type 2 diabetes. The development of insulin resistance and type 2 diabetes is propagated by aging and environmental factors.

It sounds very unfair to have your risk of disease determined before you’re even born, by factors you’re not even in control of, I know. This is why a shift from treatment to prevention is necessary, because treatment will only slow the progression of the disease at best. We can all implement preventative measures in our lifestyles (ideally as early as possible), such as improving our diet. Let’s improve our food culture so that future generations understand the importance of nutritious whole foods in preventing the development of type 2 diabetes. We have more knowledge than ever about where type 2 diabetes stems from, so it’s time to stop it at its roots. 

That is all from me for now, I hope you were able to learn a little more about type 2 diabetes (and a little more about me!). Thanks for reading and stay healthy. 


Further reading

‘Growing up in the UK – Ensuring a healthy future for our children. Fetal origins of adult disease’. Barker, D. (1997), BMA Board of Science, 1(1), pp. 149–168. Available at: https://www.bma.org.uk/media/2049/growingupinuk_may2013.pdf (Accessed 29/12/2020)

‘Developmental Origins of Health and Disease: The relevance to developing nations’. Mandy, M. and Nyirenda, M. (2018). International Health, 10(2), pp. 66–70. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5856182/ (Accessed 29/12/2020)