Fetal hyperinsulinemia is assumed to play a key role in the pathogenesis of diabetic fetopathy. To investigate the role of enhanced fetal B-cell mass as one cause of fetal hyperinsulinemia during diabetic pregnancy, we studied human fetal pancreatic slices from diabetic women (FDW) with poor metabolic control and nondiabetic women (FNDW) between 11 and 26 wk of pregnancy, morphometrically and by in vitro incubation experiments. Abortions had been performed due to different medical indications. We found a good correlation between the calculated B-cell mass and the gestational age in both FDW and FNDW, but the increase in FDW was much more pronounced. Such a correlation was also found in vitro regarding the insulin response to glucose and IBMX. The FDW had significantly higher values than FNDW of the same age range. In contrast to this, we found in two diabetic patients with tight metabolic control during the whole pregnancy results similar to those in FNDW. Therefore, we assume that it could be possible to prevent fetal hyperinsulinemia and perhaps even diabetic fetopathy in diabetic women by tight metabolic control during the whole pregnancy, but further investigations are necessary.

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The effect of a single subdiabetogenic dose of streptozotocin (30 mg/kg body weight) on pancreatic insulin content and relative beta cell volume has been studied in normoglycaemic Wistar rats treated with streptozotocin either 2, 3 or 14 days after STZ was given. A single intravenous injection of streptozotocin caused a significant reduction of pancreatic insulin content, islet and beta cell volume, accompanied by a significantly diminished islet insulin content. The glucose- and 3-isobutyl-1-methylxanthine-stimulated insulin secretion was significantly lower in islets obtained 2 or 3 days after streptozotocin injection compared with those of vehicle-treated controls. 14 days after streptozotocin injection, beta cell volume and pancreatic insulin content partially recovered. At this time islet insulin content and secretory responsiveness were enhanced compared to the early phase following streptozotocin administration. The incorporation of [3H] thymidine into islet DNA was significantly enhanced at day 2 or 3 after streptozotocin application, whereas at day 14 the DNA synthesis corresponded to values from control rats. Despite persisting normoglycaemia, the beta cell volume of streptozotocin-treated rats was only 52% vs. control values, thus indicating the unresponsiveness of residual beta cells to compensate spontaneously for the beta cell loss.

Irradiation of pancreatic rat islets up to a dose of 2.5 Gy did neither alter glucose-nor IBMX-induced insulin secretion studied in vitro. The insulin as well as glucagon content of irradiated islets were similar as in the control tissue. This was also true in islets irradiated with 25 Gy which were characterized by a decreased insulin secretion in the presence of glucose and IBMX, respectively. Since we did not find indications of an enhanced hormone output in the radiation medium, we want to suggest that higher irradiation doses affect insulin release of pancreatic islets in vitro. This observation has to be taken into account for application of radioimmunosuppression for transplantation.