Diabetic pregnancy is associated with an increased risk for fetal maldevelopment for a largely unknown reason. A decade ago, Norbert Freinkel suggested that the altered fuel mixture offered to the growing conceptus may be the key to most of the changes in the embryogenesis of diabetic pregnancy. He coined the term fuel-mediated teratogenesis. During early pregnancy, periods of maternal hyper- and hypoglycemia may cause marked changes in the availability of glucose to the conceptus. Also, increased concentrations of lipids, notably ketone bodies, and branched-chain amino acids in the maternal circulation contribute to a changed fuel mixture for the embryo. In a recent experimental study of diabetic rats, it was found that the maternal metabolism of all three major classes of nutrients and maternal somatic growth during gestation covaried with the development of the embryo. Consequently, the maintenance of normal concentrations of metabolites from all nutrient classes may be important for prevention of adverse fetal outcome in diabetic pregnancy. In vitro, a high glucose concentration causes embryonic dysmorphogenesis by generation of free oxygen radicals. An enhanced production of such radicals in embryonic tissues may be directly related to an increased risk of congenital malformations in diabetic pregnancy. Thus, the notion that alterations in the net transfer of cellular fuels from the diabetic mother to her offspring may cause embryonic dysmorphogenesis, which suggests that combustion of the fuel may produce compounds that impair embryonic development, has obtained experimental support. If this is also true for human diabetic pregnancy, it has therapeutic implications.
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December 01 1991
Diabetic Embryopathy Studies With Animal and In Vitro Models
Ulf J Eriksson;
Ulf J Eriksson
Department of Medical Cell Biology, University of Uppsala
Uppsala, Sweden
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L A Håkan Borg;
L A Håkan Borg
Department of Medical Cell Biology, University of Uppsala
Uppsala, Sweden
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Henrik Forsberg;
Henrik Forsberg
Department of Medical Cell Biology, University of Uppsala
Uppsala, Sweden
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Johan Styrud
Johan Styrud
Department of Medical Cell Biology, University of Uppsala
Uppsala, Sweden
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Address correspondence and reprint requests to Dr. Ulf J. Eriksson, Department of Medical Cell Biology, University of Uppsala, Biomedicum, PO Box 571, S-751 23 Uppsala, Sweden
Citation
Ulf J Eriksson, L A Håkan Borg, Henrik Forsberg, Johan Styrud; Diabetic Embryopathy Studies With Animal and In Vitro Models. Diabetes 1 December 1991; 40 (Supplement_2): 94–98. https://doi.org/10.2337/diab.40.2.S94
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