{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T23:42:03Z","timestamp":1788910923435,"version":"build-2803163510"},"reference-count":43,"publisher":"American Diabetes Association","issue":"12","license":[{"start":{"date-parts":[[2021,10,5]],"date-time":"2021-10-05T00:00:00Z","timestamp":1633392000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.diabetesjournals.org\/content\/license"}],"content-domain":{"domain":["diabetesjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,12,1]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>India is a double world capital of early-life undernutrition and type 2 diabetes. We aimed to characterize life course growth and metabolic trajectories in those developing glucose intolerance as young adults in the Pune Maternal Nutrition Study (PMNS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESEARCH DESIGN AND METHODS<\/jats:title>\n                    <jats:p>PMNS is a community-based intergenerational birth cohort established in 1993, with serial information on parents and children through pregnancy, childhood, and adolescence. We compared normal glucose-tolerant and glucose-intolerant participants for serial growth, estimates of insulin sensitivity and secretion (HOMA and dynamic indices), and \u03b2-cell compensation accounting for prevailing insulin sensitivity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>At 18 years (N = 619), 37% of men and 20% of women were glucose intolerant (prediabetes n = 184; diabetes n = 1) despite 48% being underweight (BMI &amp;lt;18.5 kg\/m2). Glucose-intolerant participants had higher fasting glucose from childhood. Mothers of glucose-intolerant participants had higher glycemia in pregnancy. Glucose-intolerant participants were shorter at birth. Insulin sensitivity decreased with age in all participants, and those with glucose intolerance had consistently lower compensatory insulin secretion from childhood. Participants in the highest quintile of fasting glucose at 6 and 12 years had 2.5- and 4.0-fold higher risks, respectively, of 18-year glucose intolerance; this finding was replicated in two other cohorts.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>Inadequate compensatory insulin secretory response to decreasing insulin sensitivity in early life is the major pathophysiology underlying glucose intolerance in thin rural Indians. Smaller birth size, maternal pregnancy hyperglycemia, and higher glycemia from childhood herald future glucose intolerance, mandating a strategy for diabetes prevention from early life, preferably intergenerationally.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2337\/dc20-3026","type":"journal-article","created":{"date-parts":[[2021,10,5]],"date-time":"2021-10-05T18:36:05Z","timestamp":1633458965000},"page":"2747-2757","update-policy":"https:\/\/doi.org\/10.2337\/ada-journal-policies","source":"Crossref","is-referenced-by-count":32,"title":["Poor In Utero Growth, and Reduced \u03b2-Cell Compensation and High Fasting Glucose From Childhood, Are Harbingers of Glucose Intolerance in Young Indians"],"prefix":"10.2337","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2911-2378","authenticated-orcid":false,"given":"Chittaranjan S.","family":"Yajnik","sequence":"first","affiliation":[{"name":"Diabetes Unit, King Edward Memorial (KEM) Hospital Research Centre, Pune, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Souvik","family":"Bandopadhyay","sequence":"additional","affiliation":[{"name":"Indian Institute of Public Health, Hyderabad, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aboli","family":"Bhalerao","sequence":"additional","affiliation":[{"name":"Diabetes Unit, King Edward Memorial (KEM) Hospital Research Centre, Pune, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dattatray S.","family":"Bhat","sequence":"additional","affiliation":[{"name":"Diabetes Unit, King Edward Memorial (KEM) Hospital Research Centre, Pune, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanat B.","family":"Phatak","sequence":"additional","affiliation":[{"name":"Diabetes Unit, King Edward Memorial (KEM) Hospital Research Centre, Pune, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rucha H.","family":"Wagh","sequence":"additional","affiliation":[{"name":"Diabetes Unit, King Edward Memorial (KEM) Hospital Research Centre, Pune, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pallavi C.","family":"Yajnik","sequence":"additional","affiliation":[{"name":"Diabetes Unit, King Edward Memorial (KEM) Hospital Research Centre, Pune, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anand","family":"Pandit","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, KEM Hospital Research Centre, Pune, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sheila","family":"Bhave","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, KEM Hospital Research Centre, Pune, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kurus","family":"Coyaji","sequence":"additional","affiliation":[{"name":"Diabetes Unit, King Edward Memorial (KEM) Hospital Research Centre, Pune, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kalyanaraman","family":"Kumaran","sequence":"additional","affiliation":[{"name":"Holdsworth Memorial Hospital, Mysore, India"},{"name":"Medical Research Council Lifecourse Epidemiology Centre, University of Southampton, Southampton, U.K."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clive","family":"Osmond","sequence":"additional","affiliation":[{"name":"Medical Research Council Lifecourse Epidemiology Centre, University of Southampton, Southampton, U.K."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroline H.D.","family":"Fall","sequence":"additional","affiliation":[{"name":"Medical Research Council Lifecourse Epidemiology Centre, University of Southampton, Southampton, U.K."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1167","published-online":{"date-parts":[[2021,10,5]]},"reference":[{"key":"2022031309332707100_B1","doi-asserted-by":"crossref","first-page":"e1352","DOI":"10.1016\/S2214-109X(18)30387-5","article-title":"The increasing burden of diabetes and variations among the states of India: the Global Burden of Disease Study 1990-2016","volume":"6","author":"India State-Level Disease Burden Initiative Diabetes Collaborators","year":"2018","journal-title":"Lancet Glob Health"},{"key":"2022031309332707100_B2","unstructured":"Ministry of Health and Family Welfare, Government of India, Population Council, UNICEF\n          . 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