From physiology lecture, we understand the importance of insulin and glycogen within our body. The word insulin often sparks our thought about diabetes, whether it is Type I or Type II. However, when thinking about diabetic individuals, we don’t often associate their disease as being able to affect others. Recently a news story reported about a mother giving birth to a 14-pound baby in Utah. If you aren’t aware of the average weight a newborn it is about 8.12 pounds, so this baby is almost doubled the size of an average baby. This mother chose to have her baby by caesarean section, which many mothers with large babies often choose to do. It has been reported however, that there are mothers who choose to give birth vaginally. The mother’s doctor concluded that the baby’s heaviness is a result of the mother having Type I diabetes. Studies revealed that those with Type I diabetes are unable to produce insulin from beta cells in the islet of Langerhans in the pancreas, and therefore unable to regulate glucose levels (Davis et al. 2005). Due to a higher level of glucose in the mother, the fetus’ glucose level starts to rise as well, resulting in heavier birth weight (Fee and Weil 2006). The doctor stated, “because the mother is a diabetic, it is like giving fertilizer to the baby and as a result the baby becomes very large”. In addition to being heavier, these infants are also hypoglycemic following birth because their bodies have a large amount of insulin within their blood and that they lack the higher levels of glucose directly from their mother. With that, these infants also have larger organs such as liver, adrenal glands and the heart; however, these infants often have immature lungs (Naeye 1965). Although the characteristics of these larger infants differ from the average newborn, after close monitoring during their earlier years, they often lead normal lives.
Davis RE, Morrissey M, Peters JR, Wittrup-Jensen K, Kennedy-Martin T, Currie CJ. 2005. Impact of hypoglycaemia on quality of life and productivity in type 1 and type 2 diabetes. Current Medical Research and Opinion. 21(9):1477-1483.
Fee BA, Weil WB. 2006. Body composition of infants of diabetic mothers by direct analysis. ANNALS of the New York Academy of Sciences. 110: 869-897.
Naeye RL. 1965. Infants of diabetic mothers: a quantitative, morphologic study. Pediatrics. 35 (6): 980-988.
That’s really interesting! Your post made me wonder whether babies born from a diabetic mother would have problems associated with a larger birth weight, or if the babies would have problems associated with larger organs. I couldn’t find anything directly related to that; however, I found that babies born from type 1 diabetic mothers are more likely to have congenital malformations and macrosomia (1). In addition, fetal exposure to maternal diabetes can have effects for generations to come. These effects include: macrosomic fetuses, islet proliferation, and abnormal glucose tolerance into adulthood (2). On the bright side, the risk of many of these effects decreases significantly if the mother receives preconceptional and periconceptional care ( 1).
ReplyDelete1. Evers IM, de Valk HW, Visser GH. Risk of complications of pregnancy in women with type 1 diabetes: nationwide prospective study in the Netherlands. BMJ. April 2004. 328. http://dx.doi.org/10.1136/bmj.38043.583160.EE
2. Fetita LS, Sobngwi E, Serrandas P, Calvo S, Gautier JF. Consequences of fetal exposure to maternal diabetes in offspring. JCEM. Oct. 2006. 91: 339-348.
I thought this post was interesting as well, and I have a bit of personal experience with the topic. My mom developed gestational diabetes with each of her three pregnancies (two 9 lbs. babies and one 10 lbs. baby). She's not a large woman either. The exact reason why women develop gestational diabetes is still unclear, but the same principle of elevated blood glucose levels in the mother result in larger than normal infants. There is evidence, though, that the placental growth hormone causes the mother to become slightly insulin resistant (1). The insulin resistance of the mother increases her blood glucose levels providing more glucose to the child, which causes above average growth.
ReplyDelete1. Newbern D, Freemark M. Placental hormones and the control of maternal metabolism and fetal growth. 2011. Endocrinology, Diabetes, & Obesity. 18:409-416.
This post was very interesting. In genetics, we have been talking a lot about genetic counseling for couples planning a family. This post and Melissa's comment made me wonder what current treatments are out there to help diabetic mother's. One high risk of this type of pregnancy is oxidative stress on the baby. Under the high glucose levels of the fetus, oxidative stress can cause vascular dysfunction which leads to fetal compromise (1). A recent study treated a group of mother's with type 1 diabetes with lutein (1). Lutein is a carotenoid synthesized by plants. It serves as an antioxidant when ingested (1). The infants of the mother's who were treated with lutein for the duration of their pregnancy had decreased oxidative stress markers compared to the infants of the mother's with type 1 diabetes that were not treated with lutein.
ReplyDeleteAnother article looked at the use of real time continuous glucose monitoring systems for postnatal use by diabetic mother's. This system allowed for mother's to administer glucose for the hypoglycemic infant due to the result of the monitoring system (2). By doing this, the infants showed great outcome improvement in a short period of time (2).
1. Lorenzoni F, Giampietri M, Ferri G, Lunardi S, Madrigali V, Battini L, Boldrini A, Ghirri P. Oct 2013. Lutein administration to pregnant women with gestational diabetes mellitus is associated to a decrease of oxidative stress in newborns. 29(10): 901-903.
2. Stechova K, Cerny M, Brabec R, Ulmannova T, Bartaskova D, Spalova I, Zoban P. November 2013. Experience with real time continuous glucose monitoring in stabilising fluctuating glycaemia during intensive care of the preterm infant of a diabetic mother. doi:10.3109/14767058.2013.858686
Read More: http://informahealthcare.com.dml.regis.edu/doi/full/10.3109/09513590.2013.808329