Birth weight tied to excess mortality in diabetics

It is known that the risk of death in adults with diabetes is approximately twofold that of the general population. A new study suggests that the excess mortality associated with diabetes is disproportionately concentrated among those diabetics who were singleton term infants with low or high birth weight.

This finding is important for two reasons, Dr. Cynthia L. Leibson from the Mayo Clinic in Rochester, Minnesota told Reuters Health. "The observations reinforce the need to decrease low birth weight deliveries and maintain tight control of (blood sugar) during pregnancy."

The findings also suggest that monitoring and treatment of diabetic complications and co-morbid conditions, such as high blood pressure and lipid abnormalities, are especially important in people with diabetes whose weight at birth was outside the normal range, she said.

Leibson and colleagues estimated the risk of death associated with diabetes as a function of birth weight for 171 adults with diabetes and 342 nondiabetic controls.

According to the team's report in Diabetes Care, the proportion of deaths among diabetics was more than twice that for controls (16 percent vs 7 percent). The difference was less apparent for normal-birth-weight individuals (12 percent vs 8 percent) than for high-birth-weight individuals (23 percent vs 8 percent) and low-birth-weight individuals (20 percent vs 2 percent).

The number of deaths among diabetics was greater than expected, based on the mortality for the general population, with 70 percent of excess deaths occurring among low-birth-weight and high-birth-weight individuals, the team reports.

This study, Leibson said, highlights the importance of trying to achieve normal-weight births among diabetic patients. She cautions, however, that the findings need to be replicated in future studies. The mechanisms underlying the observations also require additional study.

SOURCE: Diabetes Care 2005.