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Ruchi Jain

Postdoctoral fellow

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Perinatal famine is associated with excess risk of proliferative retinopathy in patients with type 2 diabetes


  • Olena Fedotkina
  • Andrea Luk
  • Ruchi Jain
  • Rashmi B Prasad
  • Dmitry Shungin
  • Olga Simó-Servat
  • Türküler Özgümüs
  • Liubov Cherviakova
  • Nadiya Khalimon
  • Tetiana Svietleisha
  • Tetiana Buldenko
  • Victor Kravchenko
  • Cristina Hernández
  • Deepak Jain
  • Rafael Simo
  • Isabella Artner
  • Peter M Nilsson
  • Mykola D Khalangot
  • Alexander M Vaiserman
  • Juliana Chan
  • Allan Vaag
  • Valeriya Lyssenko

Summary, in English

PURPOSE: Intrauterine undernutrition is associated with increased risk of type 2 diabetes. Children born premature or small for gestational age were reported to have abnormal retinal vascularization. However, whether intrauterine famine act as a trigger for diabetes complications, including retinopathy, is unknown. The aim of the current study was to evaluate long-term effects of perinatal famine on the risk of proliferative diabetic retinopathy (PDR).

METHODS: We studied the risk for PDR among type 2 diabetes patients exposed to perinatal famine in two independent cohorts: the Ukrainian National Diabetes Registry (UNDR) and the Hong Kong Diabetes Registry (HKDR). We analysed individuals born during the Great Famine (the Holodomor, 1932-1933) and the WWII (1941-1945) famine in 101 095 (3601 had PDR) UNDR participants. Among 3021 (251 had PDR) HKDR participants, we studied type 2 diabetes patients exposed to perinatal famine during the WWII Japanese invasion in 1942-1945.

RESULTS: During the Holodomor and WWII, perinatal famine was associated with a 1.76-fold (p = 0.019) and 3.02-fold (p = 0.001) increased risk of severe PDR in the UNDR. The risk for PDR was 1.66-fold elevated among individuals born in 1942 in the HKDR (p < 0.05). The associations between perinatal famine and PDR remained statistically significant after corrections for HbA1c in available 18 507 UNDR (padditive interaction < 0.001) and in 3021 HKDR type 2 diabetes patients (p < 0.05).

CONCLUSION: In conclusion, type 2 diabetes patients, exposed to perinatal famine, have increased risk of PDR compared to those without perinatal famine exposure. Further studies are needed to understand the underlying mechanisms and to extend this finding to other diabetes complications.


  • Islet cell physiology
  • EXODIAB: Excellence of Diabetes Research in Sweden
  • Genomics, Diabetes and Endocrinology
  • Antigen Presentation
  • Medical Protein Science
  • Endocrine Cell Differentiation and Function
  • StemTherapy: National Initiative on Stem Cells for Regenerative Therapy
  • Stem Cell Center
  • History of Medicine
  • Internal Medicine - Epidemiology
  • EpiHealth: Epidemiology for Health

Publishing year





Acta Ophthalmologica





Document type

Journal article




  • Endocrinology and Diabetes



Research group

  • Islet cell physiology
  • Genomics, Diabetes and Endocrinology
  • Antigen Presentation
  • Medical Protein Science
  • Endocrine Cell Differentiation and Function
  • Internal Medicine - Epidemiology


  • ISSN: 1755-3768