Abstract
Background: Knowing vulnerable periods of growth for predicting type 2 diabetes (T2D) incidence may help focus interventions for prevention. Using life course data, we identified critical growth periods in childhood that predict T2D risk. Methods: This analysis of a longitudinal study of American Indians, aged ≥ 5 years, comprised subjects representing three growth periods (pre-, early, and late adolescence). Age-sex-height-adjusted mean attained weight and weight velocity (change/year) were computed in each growth period. Subjects were followed from the end of each growth period until T2D diagnosis or their last research examination. Poisson regression was used to model the effects of the mean attained weight or weight velocity in a growth period on T2D incidence. Results: There were 290 incident T2D cases among 2100 subjects representing the pre-adolescence growth period, 315 cases among 1558 in the early adolescence period, and 380 cases among 1418 in the late adolescence period. In each growth period, the mean attained weight significantly predicted T2D incidence, especially in the first 5 years of follow-up (Figure, A-C). There were significant effects of weight velocity in pre-adolescence and modest effects in late adolescence on T2D incidence (Figure, D-F). Attained weight pre-adolescence had the strongest effect on T2D incidence. Conclusions: Pre-adolescence is an especially vulnerable period for predicting later T2D.