December 9, 2005

Birth weight tied to excess mortality in diabetics

NEW YORK (Reuters Health) - 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

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.