Low birth weight is a well-established risk factor for type 2 diabetes, but the risk at high birth weight levels remains uncertain. Potential sex differences in the associations are unexplored. We investigated whether sex influences the association of birth weight and adult type 2 diabetes, using a cohort of 113,801 men and 109,298 women, born 1936–1983, from the Copenhagen School Health Records Register, Denmark. During 5.6 million person-years of follow-up, 7,750 men and 4,736 women had a diagnosis of adult type 2 diabetes (30 years of age or older) obtained from national registers. When birth weights between 3.251 and 3.750 kg were used as the reference group for each sex separately, women with birth weights in the categories of 2.000 to 2.750 kg and 4.751 to 5.500 kg had hazard ratios [HRs] of type 2 diabetes of 1.46 (95% CI, 1.34–1.59) and 1.56 (1.20–2.04), respectively, whereas men had HRs of 1.20 (1.12–1.30) and 0.93 (0.76–1.15). Thus, sex modified the association, with stronger risk estimates of type 2 diabetes in women at both low and high birth weights compared with men (P = 0.001). In conclusion, birth weight is more strongly associated with type 2 diabetes in women than in men. Future search for sex-specific causal mechanisms may provide new insights into the early origins of type 2 diabetes.
Vaughn of Jacksonville, Florida, loves summer camp. Vaughn, who was diagnosed with type 1 diabetes in the fall of 2014, is like millions of other children who attend camp each year. They love camp because it’s fun, helps build great relationships and offers learning experiences that are not available most anywhere else.
So, in the spring of 2015, when Vaughn’ mother Kira got a message from camp saying he could not attend that summer, she was naturally upset. She was told, “I’m sorry for the bad news. We are not equipped to handle a camper with diabetes.”
Kira has been a paralegal for years and, with her legal background, believed that Vaughn had rights that made this situation unfair. Kira could not bring herself to tell Vaughn he couldn’t go to camp — especially that it was because of his diabetes. She knew Vaughn would not handle the news very well.
Instead, she contacted the American Diabetes Association for help.
She wrote, “My son has been begging to go to camp this summer. Telling him he can’t go would severely affect his self-esteem. I want him to have a normal camp experience like other kids. Thank you for any legal advice you can provide to help my son.”
Kira spoke with a Legal Advocate at the Association and learned that Vaughn did have legal rights.
She was told that, under federal law, Vaughn should be allowed to attend camp and provide accommodations for his diabetes care. The Legal Advocate also shared resources to help Kira discuss this with the camp organizers, such as a sample letter, tips on how to speak with administrators and hints for negotiating on behalf of her son.
Supplied with this information, Kira was able to achieve success.
The camp reversed its policy, made changes to care for Vaughn’s diabetes and allowed him to attend. Kira never even told Vaughn what had happened. He just went to camp and had a great time. Things went very well and he had no medical problems at all.
His diabetes should never have been an issue in the first place.
“I am so thankful for the American Diabetes Association. I have volunteered to get involved and help others who may not know where to turn when their child is being unjustly discriminated against.” – Kira
The American Diabetes Association leads the effort to prevent and eliminate discrimination against people with diabetes at school, at work and in other parts of daily life. If you need help, call 1-800-DIABETES or visit http://ift.tt/1zCIiW2.
Through our nationwide Safe at School program, the Association is dedicated to making sure that all children with diabetes are medically safe at school and have the same educational opportunities as their peers. Visit our Safe at School website for information and resources.
Give the gift of fairness — donate now to help people with diabetes facing discrimination, just like Vaughn.
