Fetal hyperinsulinemia causes fetal arterial hypoxia because fetal O2 use increases, whereas the supply of O2 to the fetus does not. To find which of the fetal tissues accounts for such an increase in fetal O2 use, we examined the effect of plasma hyperinsulinemia on O2, glucose, and lactate use by the hindquarters of 13 fetal sheep. Spinal anesthesia was used for the ewes, and local anesthesia was used for the fetuses during placement of catheters. The ewes then recovered for 5 days. After 18 h of insulin infusion, blood samples were drawn, and microspheres were injected to measure blood flow to the tissues of the hindquarters. Three to five infusions of various insulin concentrations in each fetus were followed by blood sampling and blood-flow measurements. Fetal hyperinsulinemia (≤437 pM) increased blood flow to and O2 use by the hindquarters of the fetal sheep but did not affect the glucose-O2 quotients of these tissues. Consequently, glucose use increased proportionately to the increased O2 use. Lactate production was not affected by insulin. We conclude that increased O2 use by all the nonvisceral fetal tissues accounted for the increased O2 use of the entire fetus reported during fetal hyperinsulinemia and, consequently, for the fetal arterial hypoxemia associated with fetal hyperinsulinemia. If the hyperinsulinemic human fetus (such as the infant of the diabetic mother) also increases O2 use in nonvisceral tissue, such an increase might contribute to the susceptibility of the infants to late intrauterine fetal death, polycythemia, and hyperbilirubinemia, all of which may be consequences of intrauterine arterial hypoxemia.
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Original Articles|
May 01 1989
Effect of Insulin on Metabolism of Fetal Sheep Hindquarters
J Ross Milley;
J Ross Milley
Division of Neonatology, Department of Pediatrics, University of Pittsburgh School of Medicine
Pittsburgh, Pennsylvania
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Julie S Papacostas
Julie S Papacostas
Division of Neonatology, Department of Pediatrics, University of Pittsburgh School of Medicine
Pittsburgh, Pennsylvania
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Address correspondence and reprint requests to J. Ross Milley, MD, PhD, Department of Pediatrics, Division of Neonatology, University of Utah School of Medicine, 50 N. Medical Drive, Salt Lake City, UT 84132.
Diabetes 1989;38(5):597–603
Article history
Received:
March 28 1988
Revision Received:
December 01 1988
Accepted:
December 01 1988
PubMed:
2653930
Citation
J Ross Milley, Julie S Papacostas; Effect of Insulin on Metabolism of Fetal Sheep Hindquarters. Diabetes 1 May 1989; 38 (5): 597–603. https://doi.org/10.2337/diab.38.5.597
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