Low birthweight is associated with a higher incidence of type 2 diabetes over two decades independent of adult BMI and genetic predisposition

Rasmus Wibaek*, Gregers S Andersen, Allan Linneberg, Torben Hansen, Niels Grarup, Anne Cathrine B Thuesen, Rasmus T Jensen, Jonathan C K Wells, Kasper A Pilgaard, Charlotte Brøns, Dorte Vistisen, Allan A Vaag

*Corresponding author for this work


AIMS/HYPOTHESIS: Low birthweight is a risk factor for type 2 diabetes. Most previous studies are based on cross-sectional prevalence data, not designed to study the timing of onset of type 2 diabetes in relation to birthweight. We aimed to examine associations of birthweight with age-specific incidence rate of type 2 diabetes in middle-aged to older adults over two decades.

METHODS: Adults aged 30-60 years enrolled in the Danish Inter99 cohort in 1999-2001 (baseline examination), with information on birthweight from original birth records from 1939-1971 and without diabetes at baseline, were eligible. Birth records were linked with individual-level data on age at diabetes diagnosis and key covariates. Incidence rates of type 2 diabetes as a function of age, sex and birthweight were modelled using Poisson regression, adjusting for prematurity status at birth, parity, polygenic scores for birthweight and type 2 diabetes, maternal and paternal diabetes history, socioeconomic status and adult BMI.

RESULTS: In 4590 participants there were 492 incident type 2 diabetes cases during a mean follow-up of 19 years. Type 2 diabetes incidence rate increased with age, was higher in male participants, and decreased with increasing birthweight (incidence rate ratio [95% CI per 1 kg increase in birthweight] 0.60 [0.48, 0.75]). The inverse association of birthweight with type 2 diabetes incidence was statistically significant across all models and in sensitivity analysis.

CONCLUSIONS/INTERPRETATION: A lower birthweight was associated with increased risk of developing type 2 diabetes independent of adult BMI and genetic risk of type 2 diabetes and birthweight.

Original languageEnglish
Issue number9
Pages (from-to)1669-1679
Number of pages11
Publication statusPublished - Sep 2023


  • Birthweight
  • Cohort
  • Developmental origins
  • Fetal programming
  • Genetic susceptibility
  • Low birthweight
  • Type 2 diabetes
  • Body Mass Index
  • Genetic Predisposition to Disease
  • Cross-Sectional Studies
  • Humans
  • Middle Aged
  • Male
  • Birth Weight/genetics
  • Diabetes Mellitus, Type 2/epidemiology
  • Incidence
  • Pregnancy
  • Female
  • Aged
  • Infant, Newborn


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