Elaine de Oliveira, Patricia Cristina Lisboa and Egberto Gaspar de Moura
Diabetes and its complications occur at high rates in the world population. Several epidemiological studies have associated perinatal adversities, such as nutritional disturbances or diseases during gestation and lactation, with the development of insulin resistance or failure on insulin secretion in the adult progeny. Only recently the mechanism by which this phenomenon occurs is being delineated through series of experimental studies and implies epigenetics changes as a main initializing event. In this review, the authors give a comprehensive report of the different models of fetal and developmental programming that can result either in insulin resistance or insulin inappropriate secretion, with the possible mechanistic explanation for these alterations. The changes in the female workforce, which implies in profound nutritional and hormonal changes, exposure to endocrine disruptor or addictive compounds during gestation and lactation, including the reduction of lactation period creates conditions that, are obesogenic for their progenies, increasing the risk of type 2 diabetes mellitus. Finally, neonatal insults might be an important ethiopathogenic factor for the development of metabolic disturbances in adulthood, including obesity and diabetes, contributing to the considerable increase in chronic diseases incidence in society.
