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Birthweight and fasting glucose and insulin levels: results from the Aboriginal Birth Cohort Study

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The concerning rise in type 2 diabetes in Indigenous populations continues, with different hypotheses put forward to explain the phenomenon. International evidence links the fetal nutrition proxies of low birthweight (LBW) and fetal growth restriction (FGR) to chronic diseases in adult life.1 The developmental origins of health and disease (DOHaD) hypothesis states that undernutrition in utero results in permanent changes through epigenetic mechanisms that later influence disease development (http://www.mrc. soton.ac.uk/dohad). The highest risk for type 2 diabetes is reported when LBW or FGR is followed by later overweight or obesity, suggesting a mismatch between intrauterine and postnatal nutrition.2

Despite recent improvements, Australian Aboriginal LBW rates remain double those of the non-Aboriginal population.3 National Aboriginal rates of FGR are unknown, but in a Northern Territory study, 25% of Aboriginal newborns were defined as fetal growth restricted.4

Concurrently, not only are Australian Indigenous…