Congenital Anomalies and Diabetes in the Pima Indians of Arizona

Abstract

Medical records of 1,207 Pima Indian children were examined for reported congenital anomalies. Anomalies occurred in eight (38.1 per cent) of twenty-one offspring born after the onset of diabetes to mothers whose disease was diagnosed before age twenty-five, but in only 3.7 per cent of the offspring of all other women. Children born after the onset of diabetes to mothers whose disease started at or after age twenty-five, and those born to prediabetic mothers had anomalies no more frequently than the children of nondiabetic mothers. Congenital anomalies were not related to paternal diabetes. Anomalies were more frequent in children from “diabetic” pregnancies during which the mother required hypoglycemic medication than from those during which medication was not required. Although a genetic mechanism cannot be completely excluded, the data better support the hypothesis that diabetes produced fetal anomalies among the Pima Indians by its influence upon the intrauterine environment during early pregnancy.

Caudal Regression Syndrome in Twin Pregnancy With Type II Diabetes

“…Apparently, diabetic fathers do not have an effect on development of congenital malformations in their offspring. 17 Conversely, teratogenicity of hyperglycemia appears to be enhanced in the presence of genetically predisposed rat embryos of diabetic mothers. 18 Moreover, maternal diabetes alters gene expression of extracellular matrix components in developing rat embryos.…”

D-glucose-induced dysmorphogenesis of embryonic kidney.

“…The pathologic changes of the kidney are characterized by biochemical alterations of the extracellular matrix (ECM) 1 macromolecules; the latter are believed to regulate morphogenesis of different organ systems (3,4). In this regard, a significant increase in the congenital defects, involving multiple organs, in the offsprings of poorly controlled juvenile diabetic mothers have been described (5)(6)(7)(8)(9). The congenital defects include failure in the closure of neural tube, caudal regression syndrome, and genito-urinary abnormalities, including agenesis of the kidney.…”

İnsan Ve Hayvanlarda Di̇abetes Melli̇tus

“…Gebelik diyabeti için risk grupları arasında önceden glikoz intoleransı tespit edilmiş ileri yaştaki kadınlar, önceki gebeliklerinde aşırı kilolu bebek doğuran kadın-lar, tekrarlayan düşük, ölü doğum gibi kötü gestasyon hikayesi olanlar, Tip 2 diyabetin sık görüldüğü etnik gruplardan olanlar ve açlık glikoz düzeyleri yüksek olan kadınlar sayılabilir. Diyabet anne ve fetüs için tehlikelidir, yükselen açlık glikozu gebeliğin 4-8 haftalık dönemlerinde konjenital anomali ve intrauterin ölüme sebep olabilir (14). DM, oldukça yaygın ancak hem değişik toplumlarda hem de aynı toplumun değişik kesimlerinde farklı yüzdelerde görülen kalıtsal, sistemik aynı zamanda sosyal ve ekonomik yönleri ağır basan bir hastalıktır.…”