Effects of size at birth, gestational age and early growth in preterm infants on glucose and insulin concentrations at 9-12 years

Diabetologia. 2000 Jun;43(6):714-7. doi: 10.1007/s001250051368.


Aims/hypothesis: To test the hypothesis that small size for gestation and poor postnatal growth in preterm infants is associated with higher fasting and post-load plasma glucose and insulin concentrations at 9-12 years of age.

Methods: Prospective follow-up at 9-12 years of 385 preterm children with birth weight less than 1850 g, who had anthropometry recorded at birth, 18 months and 7 years. Fasting plasma glucose, insulin, proinsulin and 32.33 split proinsulin concentrations and glucose and insulin concentrations 30 min after a standard glucose load were measured.

Results: Post-load glucose concentrations were negatively related to birth weight, independently of gestation or subsequent growth. Fasting split proinsulin and 30-min insulin concentrations were highest in children who showed the greatest increase in weight centile between birth and current follow-up, regardless of gestation. When weight during childhood was included, birthweight centile was, however, no longer statistically significant: concentrations of fasting, split, proinsulin and 30-min insulin were highest in those children who had shown the greatest increase in weight centile between 18 months of age and current follow-up, with no evidence of a greater effect in those who were smallest at 18 months.

Conclusion/interpretation: Our findings suggest that fetal growth influences plasma glucose 30 min after a glucose load in preterm children at 9-12 years. In contrast, childhood weight gain is the most important factor influencing insulin concentrations and this effect is the same regardless of early size.

Publication types

  • Clinical Trial
  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Blood Glucose / metabolism*
  • Body Constitution*
  • Child
  • Female
  • Gestational Age*
  • Growth
  • Humans
  • Infant, Newborn
  • Infant, Premature*
  • Insulin / blood*
  • Longitudinal Studies
  • Male
  • Proinsulin / blood
  • Protein Precursors / blood


  • Blood Glucose
  • Insulin
  • Protein Precursors
  • proinsulin, des(31,32)-
  • Proinsulin