Research Horizons


Predicting Adult Type 2 Diabetes from Childhood Body Mass Index, Fasting Glucose, and Insulin

What can childhood measurements tell us about adult type 2 diabetes mellitus (T2DM)? In a large, longitudinal study published in Diabetes Care, our research team examined childhood body mass index (BMI), fasting glucose, and insulin in relation to T2DM.

We began with data from The International Childhood Cardiovascular Cohort Consortium obtained during the 1970s-1990s, including measurements from participants aged 3-19 years. Next, we followed up with 6,738 of these participants from 2015 to 2019, asking them to complete a health questionnaire and self-report of adult T2DM.

Among the participants, 6.5 percent reported onset of T2DM between ages 20 and 59 years, with 86 percent of them reporting use of an antidiabetic medication. We found that as childhood levels of BMI and glucose had increased, these measurements were related to an incrementally increased risk of T2DM beginning at age 30 years. Insulin was also positively associated with adult T2DM.

Our findings suggest that both BMI and fasting glucose measurements in children can independently and jointly help predict T2DM onset in adulthood, even at levels that are currently below clinical thresholds for risk.

These results indicate that providers should monitor their patients during well-child visits as they get close to or exceed the current BMI and glucose risk thresholds. This is especially true for children who are approaching both of these thresholds.

While this study does not imply that at-risk children should necessarily undergo treatment to reduce risks, counseling regarding a healthy lifestyle may be important. In patients with BMIs in the overweight or obese range, assessment of fasting glucose, and perhaps insulin, may be warranted to further assess risk and counsel lifestyle modifications.

Overall, this study highlights the importance of preventing obesity in childhood to prevent adult disease. Providers, parents, and schools should work together to focus on establishing and encouraging healthy lifestyles for children, including a diet rich in fruits and vegetables and sufficient physical activity.

Post authored by Jessica Woo, MHSA, PhD


Publication Information
Original title: Childhood BMI and Fasting Glucose and Insulin Predict Adult Type 2 Diabetes: The International Childhood Cardiovascular Cohort (i3C) Consortium
Published in: Diabetes Care
Publish date: September 2020
Read the Study