The Fetal Origins of Type 2 Diabetes Mellitus (1999)

Editorials16 February 1999The Fetal Origins of Type 2 Diabetes MellitusDavid J.P. Barker, MD, PhD, FRSDavid J.P. Barker, MD, PhD, FRSUniversity of Southampton; Southampton SO16 6YD, United Kingdom (Barker)Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-130-4-199902160-00019 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Like other living creatures, human beings are "plastic" in early life and are molded by the environment. Although the growth of a fetus is influenced by its genes, studies in humans and animals suggest that this growth is usually limited by the environment, particularly by the nutrients and oxygen the fetus receives (1). There are many possible evolutionary advantages in the tendency of the body to remain plastic during development rather than have its development driven only by genetic instructions acquired at conception (2). Studies in animals show that a fetus may adapt to malnutrition by altering hormone production or ...References1. McCance RA, Widdowson EM. The determinants of growth and form. Proc R Soc Lond B Biol Sci. 1974;185:1-17. CrossrefMedlineGoogle Scholar2. Stearns SC, ed. Evolution in Health and Disease. Oxford: Oxford Univ Pr; 1998. Google Scholar3. Barker DJP. Mothers, Babies, and Health in Later Life. 2d ed. Edinburgh: Churchill Livingstone; 1998. Google Scholar4. Barker DJ, Gluckman PD, Godfrey KM, Harding JE, Owens JA, Robinson JS. Fetal nutrition and cardiovascular disease in adult life. Lancet. 1993;341:938-41. CrossrefMedlineGoogle Scholar5. Fowden AL. The role of insulin in prenatal growth. J Dev Physiol. 1989;12:173-82. MedlineGoogle Scholar6. Hales CN, Desai M, Ozanne SE, Crowther NJ. Fishing in the stream of diabetes: from measuring insulin to the control of fetal organogenesis. Biochem Soc Tran. 1996;24:341-50. CrossrefMedlineGoogle Scholar7. Hales CN, Barker DJ, Clark PM, Cox LJ, Fall C, Osmond C, et al . Fetal and infant growth and impaired glucose tolerance at age 64. BMJ. 1991;303:1019-22. CrossrefMedlineGoogle Scholar8. Barker DJ. Fetal origins of coronary heart disease. BMJ. 1995;311:171-4. CrossrefMedlineGoogle Scholar9. Lithell HO, McKeigue PM, Berglund L, Mohsen R, Lithell UB, Leon DA. Relation of size at birth to non-insulin dependent diabetes and insulin concentrations in men aged 50-60 years. BMJ. 1996;312:406-10. CrossrefMedlineGoogle Scholar10. McCance DR, Pettitt DJ, Hanson RL, Jacobsson LT, Knowler WC, Bennett PH. Birth weight and non-insulin dependent diabetes: thrifty genotype, thrifty phenotype, or surviving small baby genotype? BMJ. 1994;308:942-5. CrossrefMedlineGoogle Scholar11. Harding JE, Johnston BM. Nutrition and fetal growth. Reprod Fertil Dev. 1995;7:539-47. CrossrefMedlineGoogle Scholar12. Phillips DI. Insulin resistance as a programmed response to fetal undernutrition. Diabetologia. 1996;39:1119-22. CrossrefMedlineGoogle Scholar13. Rich-Edwards JW, Colditz GA, Stampfer MJ, Willett WC, Gillman MW, Hennekens CH, et al . Birthweight and the risk for type 2 diabetes mellitus in adult women. Ann Intern Med. 1999;130:278-84. LinkGoogle Scholar14. Fall CH, Stein CE, Kumaran K, Cox V, Osmond C, Barker DJ, et al . Size at birth, maternal weight, and type 2 diabetes in South India. Diabet Med. 1998;15:220-7. CrossrefMedlineGoogle Scholar15. Farmer G, Russell G, Hamilton-Nicol DR, Ogenbede HO, Ross IS, Pearson DW, et al . The influence of maternal glucose metabolism on fetal growth, development and morbidity in 917 singleton pregnancies in nondiabetic women. Diabetologia. 1988;31:134-41. CrossrefMedlineGoogle Scholar16. Kramer MS, Joseph KS. Enigma of fetal/infant-origins hypothesis. Lancet. 1996;348:1254-5. CrossrefMedlineGoogle Scholar17. Paneth N, Susser M. Early origin of coronary heart disease (the "Barker hypothesis") [Editorial]. BMJ. 1995;310:411-2. CrossrefMedlineGoogle Scholar18. Diabetes mellitus: challenges and opportunities. Report and recommendations of the Trans-NIH Symposium: September 4-5, 1997. Google Scholar19. Ravelli AC, van der Meulen JH, Michels RP, Osmond C, Barker DJ, Hales CN, et al . Glucose tolerance in adults after prenatal exposure to famine. Lancet. 1998;351:173-7. CrossrefMedlineGoogle Scholar20. Forrester TE, Wilks RJ, Bennett FI, Simeon D, Osmond C, Allen M, et al . Fetal growth and cardiovascular risk factors in Jamaican schoolchildren. BMJ. 1996;312:156-60. CrossrefMedlineGoogle Scholar21. Yajnik CS, Fall CH, Vaidya U, Pandit AN, Bavdekar A, Bhat DS, et al . Fetal growth and glucose insulin metabolism in four-year-old Indian children. Diabet Med. 1995;12:330-6. CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: David J.P. Barker, MD, PhD, FRSAffiliations: University of Southampton; Southampton SO16 6YD, United Kingdom (Barker)Corresponding Author: David J.P. Barker, MD, PhD, FRS, MRC Environmental Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton SO16 6YD, United Kingdom. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoBirthweight and the Risk for Type 2 Diabetes Mellitus in Adult Women Janet W. Rich-Edwards , Graham A. Colditz , Meir J. Stampfer , Walter C. Willett , Matthew W. Gillman , Charles H. Hennekens , Frank E. Speizer , and JoAnn E. 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metabolismInsulinMalnutritionNutrientsPregnancyType 2 diabetes ePublished: 15 August 2000 Issue Published: 16 February 1999 Copyright & PermissionsCopyright © 1999 by American College of Physicians. 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