2005, Number 10
<< Back Next >>
Ginecol Obstet Mex 2005; 73 (10)
Effect of maternal diabetes on human and rat fetal development
Polanco PAC, Revilla MMC, Palomino GMA, Islas AS
Language: Spanish
References: 32
Page: 544-553
PDF size: 72.45 Kb.
ABSTRACT
Diabetes is a genetically determined metabolic disease with fasting hyperglycemia due to relative or absolute absence of insulin. With the use of exogenous insulin, successful gestations are now possible. Nevertheless, there are still severe problems associated, such as spontaneous abortion, perinatal mortality and congenital malformations. Caudal regression syndrome, disclosure of the neural tube and cardiovascular alterations are the most common malformations. Gestational diabetes can induce increased fetal corporal fat and macrosomia with hyperinsulinemia, hypoglycemic, hypoxia, metabolic acidosis and perinatal death. During adult life, diabetic mothers’ children can develop obesity, glucose intolerance and type 2 diabetes. In order to study fetuses’ alterations during diabetic gestations we now have animal models of diabetes. Maternal diabetes in rats alters fetal development in a very similar manner to that of humans. Although we do not accurately know the pathogenic mechanism by which diabetes produces fetuses’ abnormal development, hyperglycemia and hyperketonemia had been mentioned to have predominant roles. Hyperglycemia damages DNA and increases oxidative stress and hyperketonemia increases the rate of embryo malformations. The addition of antioxidants such as C and E vitamins can reduce this damage. During adult life, diabetic rats’ cubs have alterations in glucose metabolism and in reproductive function. The understanding of mechanisms by which maternal diabetes affects fetuses development, can help us to prevent complications and improve mothers’ and children’s life quality.
REFERENCES
Islas S, Revilla MC. Diabetes mellitus: Concepto y nueva clasificación. En: Islas S, Revilla-Monsalve C, editores. Diabetes mellitus. 3ª ed. México: McGraw-Hill Interamericana, 2004;Sección I,cap.1;pp:3-20.
García-Carrapato MR. The offspring of gestational diabetes. J Perinat Med 2003;31:5-11.
Holness MJ, Langdown ML, Sugden MC. Early-life programming of susceptibility to dysregulation of glucose metabolism and the development of type 2 diabetes mellitus. Biochem J 2000;349:657-65.
Rosenn B, Miodovnik M, Combs CA, Khoury J, Siddiqi TA. Glycemic thresholds for spontaneous abortion and congenital malformation in insulin dependent diabetes mellitus. Obstet Gynecol 1994;84:515-20.
Mills JL, Baker L, Goldman AS. Malformations in infants of diabetic mothers occur before the seventh gestational week. Implications for treatment. Diabetes 1979;28(4):292-3.
Reece EA, Homko CJ, Wu YK, et al. Metabolic fuel mixtures and diabetic embryopathy. Clin Perinatol 1993;20(3):517-32.
Jaquet D, Tregouet DA, Godefroy T, et al. Combined effects of genetic and environmental factors on insulin resistance associated with reduced fetal growth. Diabetes 2002;51:3473-8.
Nordstrom L, Spetz E, Wallstrom K, et al. Metabolic control and pregnancy outcome among women with insulin-dependent diabetes mellitus. A twelve-year follow-up in the country of Jamtland, Sweden. Acta Obst Gynecol Scand 1998;77:284-9.
Ong CYT, Lao TT, Spencer K, Nicolaides KH. Maternal serum level of placental growth factor in diabetic pregnancies. J Reprod Med 2004;49(6):477-80.
Babawale MO, Lovat S, Mayhew TM, et al. Effects of gestational diabetes on junctional adhesion molecules in human term placental vasculature. Diabetologia 2000;43:1185-96.
Loredo E. Efecto de la diabetes materna sobre la estructura de la placenta de 20 días de desarrollo. Tesis para obtener la licenciatura en Biología, Facultad de Ciencias, UNAM, México, 2003.
Von Herrath M, Bach JF. Juvenile autoimmune diabetes: a pathogenic role for maternal antibodies? Nat Med 2002;8:331-3.
Koczwara K, Bonifacio E, Ziegler AG. Transmission of maternal islet antibodies and risk of autoimmune diabetes in offspring of mothers with type 1 diabetes. Diabetes 2004;53(1):1-4.
Aerts L, Van Assche FA. Intra-uterine transmission of disease. Placenta 2003;24:905-11.
Rizzo TA, Metzger BE, Dooley SL, et al. Early malnutrition and child neurobehavioral development: Insight from the study of children of diabetic mothers. Child Dev 1997;68:26-38.
Baird JD, Aerts L. Research priorities in diabetic pregnancy today: the role of animal models. Biol Neonate 1987;51:119-27.
Hellerstrom C, Swenne I, Eriksson UJ. Is there an animal model for gestational diabetes? Diabetes 1985;34(Suppl 2):28-31.
Polanco A. Efecto de la diabetes inducida sobre la gestación y el desarrollo de las crías de ratas. Tesis presentada para obtener el grado de Maestría en Biología de la Reproducción, Escuela Nacional de Estudios Profesionales Iztacala, UNAM, México, 2001.
Ziegler B, Noack S, Diaz-Alonso JM, et al. Effect on pregnancy on B-cell replication and insulin content in normoglycemic rats with a reduced B-cell mass. Diabetologia 1983;25:129-207.
Boloker J, Gertz SJ, Simmons RA. Gestational diabetes leads to the development of diabetes in adulthood in the rat. Diabetes 2002;51:1499-506.
Palomino-Garibay MA, Revilla-Monsalve MA, Cárdenas-Sánchez A, et al. Efecto de la diabetes inducida sobre la reproducción y el desarrollo. Ginecol Obstet Méx 1998;66(10):403-6.
Buchanan TA, Denno KM, Sipos GF, et al. Diabetic teratogenesis. In vitro evidence for a multifactorial etiology with little contribution from glucose per se. Diabetes 1994;43:656-60.
Lee AT, Plump A, Cerami A, et al. Diabetes-induced teratogenesis: Role of DNA damage in a transgenic mouse model. Diabetes 1993;42(suppl 1):85A.
Ornoy A, Zaken V, Kohen R. Role of reactive oxygen species (ROS) in the diabetes-induced anomalies in rat embryos in vitro: reduction in antioxidant enzymes and low-molecular-weight antioxidants (LMWA) may be the causative factor for increased anomalies. Teratology 1999;60(6):376-86.
Wentzel P, Ejdesjo A, Eriksson UJ. Maternal diabetes in vivo and high glucose in vitro diminish GAPDH activity in rat embryos. Diabetes 2003;52:1222-8.
Cederberg J, Basur S, Eriksson UJ. Increased rate of lipid peroxidation and protein carbonylation in experimental diabetic pregnancy. Diabetologia 2001;44:766-74.
Eriksson UJ, Borg LA. Protection by free oxygen radical scavenging enzymes against glucose-induced embryonic malformations in vitro. Diabetologia 1991;34:325-31.
Cederberg J, Siman CM, Eriksson UJ. Combined treatment with vitamin E and vitamin C decreases oxidative stress and improves fetal outcome in experimental diabetic pregnancy. Pediatr Res 2001;49:755-62.
Freinkel N, Crockroft DL, Lewis MJ, et al. The 1986 McCollum award lecture. Fuel-mediated teratogenesis during early organogenesis: the effect of increased concentrations of glucose, ketones or somatomedin inhibitor during rat embryo culture. Am J Clin Nutr 1986;44:986-95.
Gauguier D, Bihoreau MT, Ktorza A, et al. Inheritance of diabetes mellitus as consequence of gestational hyperglycemia in rats. Diabetes 1990;39(6):734-9.
Babichev VN, Shishkina IV. Development of the reproductive system in the progeny of rats with streptozotocin diabetes. Prob Endokrinol (Mosk) 1994;40(2):60-62.
Palomino MA. Tesis presentada para obtener el grado de Maestría en Biología de la Reproducción, Facultad de Estudios Superiores, Iztacala, UNAM, México, 2001.