Researchers find that cases of type 2 diabetes more than double seven decades after exposure to famine

Researchers from the Columbia University Mailman School of Public Health, the University of North Carolina at Chapel Hill, and the National Academy of Sciences of Ukraine used the setting of the man-made Ukrainian Holodomor famine of 1932–1933 to investigate the relationship between prenatal famine and adult type 2 diabetes mellitus (T2DM).

They studied 128,225 cases of type 2 diabetes diagnosed between 2000 and 2008 among 10,186,016 male and female Ukrainians born between 1930 and 1938.

According to a study led by the Columbia University Mailman School of Public Health, individuals exposed to the famine in early pregnancy had more than twofold the risk of developing type 2 diabetes compared to those who were not exposed to the famine. The results are published in the news Science.

The famine led to 4 million additional deaths in the short term, with losses concentrated over a six-month period. The Holodomor far surpassed other famines in terms of intensity. Life expectancy at birth in 1933 was only 7.2 years for women and 4.3 years for men.

“The situation in Ukraine provided an unusual opportunity to examine the long-term impact of the Holodomor – or death by starvation – on cases of type 2 diabetes mellitus diagnosed seven decades after exposure to prenatal famine,” said LH Lumey, MD, professor of epidemiology to Columbia. Public health.

“With the famine concentrated over a six-month period in early 1933, we are able to determine the timing of the famine, along with extreme variations in intensity across provinces.”

This concentration was the result of Stalin’s use of famine as a weapon of terror against Ukrainian peasants. When Ukraine could not fulfill its grain purchase quotas to the Soviet Union’s central government because they did not have enough for themselves, drastic measures were taken to fulfill the grain quotas, under the excuse that counter-revolutionary elements were sabotaging the grain purchases.

A nationwide campaign of searches of farm homes in search of ‘hidden’ or ‘stolen’ grain was launched in late 1932 and expanded in early 1933. During many of these searches, all or most of the food was seized, leaving families without food. the rest of the winter. In addition, measures were taken that limited the travel of Ukrainian farmers in search of food.

These measures created a perfect storm. Many rural families were left without food; opportunities to forage for food were closed and grain reserves were depleted.

Thousands of rural families were condemned to a slow death by starvation in their villages. The result was an extraordinary increase in deaths in Holodomor between January and June 1933.

At the height of the famine in June 1933, there was an average of 28,000 famine-related deaths per day due to the famine, equivalent to 1,167 deaths per hour or 19 per minute.

“Our research on the long-term health consequences of the Holodomor famine offers several crucial lessons for addressing health problems resulting from national disasters,” Lumey notes.

“It underlines the need for a comprehensive health care and policy framework that takes into account the lasting effects of early life adversities on public health and their potential long-term consequences for chronic disease and mental health.”

Although individuals diagnosed with T2DM in 2000–2008 may also be overweight or obese and have other risk factors for the disease, the relationship between risk of T2DM in adults and place and date of birth at the time of the famine is so specific that exposure to famine in According to the research team, early pregnancy appears to be the dominant factor overriding all others.

“This awareness should spur a proactive approach among policymakers and public health officials to anticipate the increased health care needs of populations affected by national disasters. It also highlights the importance of raising awareness about the potential long-term health effects of early life adversity,” Lumey noted.

“In addition to the need to develop policies to address long-term health challenges following a national disaster, the results of our study underscore the importance of policies aimed at preventing events like the Holodomor from happening again. The Russian invasion of Ukraine in 2022 shows that history is repeating itself,” said Dr. Wolowyna of the University of North Carolina at Chapel Hill.

“The three-month siege in 2022 of the city of Mariupol during the current war in Ukraine to starve and surrender the population reminds us of a current and real danger. The blockade of Ukrainian ports to prevent the export of Ukrainian grain to developing countries in Africa and Asia has increased the risk of famine for millions of people in these countries.”