INS and diabetes mellitus: Previous studies have suggested several possible mechanisms for the increased risk of cardiovascular diseases, hypertension, and diabetes among those with LBW.27,28 Examples include metabolic stress amplified during critical periods of fetal growth, resulting in epigenetic changes, decreased leptin levels, reduced nephron counts, and altered intracellular insulin signaling pathways, all of which could lead to crucial disruptions to the endocrine and cardiovascular systems later in life.3,27,28