Send to

Choose Destination
See comment in PubMed Commons below
Diabetes. 2009 Jun;58(6):1350-5. doi: 10.2337/db08-1714. Epub 2009 Mar 31.

Increased risk of type 2 diabetes in elderly twins.

Author information

  • 1Steno Diabetes Center, Gentofte, Denmark.



Genetic susceptibility, low birth weight (LBW), and aging are key etiological factors in the development of type 2 diabetes. LBW is common among twins. It is unknown whether twin status per se is associated with risk of type 2 diabetes, and valid concordance rates of type 2 diabetes in twins on a lifetime perspective are lacking.


A clinical study was done on a population-based cohort of same-sex elderly monozygotic (MZ) and dizygotic (DZ) twins (n = 297) and singleton control subjects (C) (n = 71) including measures of anthropometry and glucose tolerance. In addition, type 2 diabetes incidence cases in twins (n = 626) and singletons (n = 553) were identified through the National Diabetes Register.


Twins were more abdominally obese, insulin resistant, and glucose intolerant, as evidenced by a higher A1C (%) (means +/- SD) (MZ: 6.0 +/- 1.0, DZ: 5.8 +/- 0.7, C: 5.6 +/- 0.3, P = 0.004) and 120-min post-oral glucose tolerance test plasma glucose levels (in mmol/l) (MZ: 8.6 +/- 4.6, DZ: 8.4 +/- 3.9, C: 6.8 +/- 2.4, P = 0.003) compared with singletons. Importantly, twins had a higher prevalence of type 2 diabetes (MZ: 17.5% [95% CI 14.4-20.6], DZ: 15.7% [13.1-18.3], C: 5.6% [3.0-8.2], P = 0.03) together with a 60% higher incidence rate of type 2 diabetes compared with singletons. Cumulative concordance rates of type 2 diabetes to the age of 84 years were similar among elderly MZ (0.76 [0.68-0.84]) and DZ (0.71 [0.63-0.78]) twins.


Twin status per se is associated with abdominal obesity, insulin resistance, and increased prevalence of type 2 diabetes in elderly twins. The data support a quantitatively significant impact of the fetal environment as opposed to genetics on risk of type 2 diabetes.

[PubMed - indexed for MEDLINE]
Free PMC Article
PubMed Commons home

PubMed Commons

How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for HighWire Icon for PubMed Central
    Loading ...
    Write to the Help Desk