Further Evidence for a Preventive Therapy of Insulin-Dependent Diabetes Mellitus in the Offspring by Avoiding Maternal Hyperglycaemia during Pregnancy

Abstract

A highly significantly decreased prevalence of insulin-dependent childhood-onset diabetes (less than 1/3 of the initial prevalence rate) could be achieved in Berlin/GDR since 1973 by improving systematically diagnostic and therapeutic measures for pregnant diabetics, particularly for non-insulin-dependent gestational diabetics. In addition, a highly significantly increased incidence rate of diagnosed, diet-treated and delivered non-insulin-dependent pregnant diabetics was found between 1979 and 1983 in Berlin/GDR, Halle and Leipzig as compared to the other districts of the GDR. Simultaneously, a highly significantly decreased prevalence rate of diabetic children (less than 1/3), who were born during this period, was found in 1983 for Berlin, Halle and Leipzig as compared to the other districts of the GDR. Finally, a highly significant inverse correlation could be demonstrated for the 15 districts of the GDR between the incidence rates of diagnosed, diet-treated and delivered non-insulin-dependent pregnant diabetics and the prevalence rates of diabetic children who were born during this period (1979-1983). In view of these findings, an interruption and even a reversal of the continued dramatic increase of idiopathic insulin-dependent diabetes mellitus appears to be possible in the developed countries by preventing maternal hyperglycaemia during pregnancy and hence hyperinsulinism in the foetuses and newborns.

Lifelong Enhanced Diabetes Susceptibility and Obesity after Temporary Intrahypothalamic Hyperinsulinism during Brain Organization

“…Therefore, a prophylaxis of such enhanced diabetes risk appeared to be possible by systematic prevention of all forms of gestational hyperglycaemia and, hence, of fetal and neonatal hyperinsulinism. Indeed, the possible success of those prophylactic measures could be impressively confirmed by epidemiological studies of our group (Dörner et al, 1985 and1987). Meanwhile, a teratogenetic relevance of gestational hyperglycaemia was also postulated by some other groups.…”

Teratogenetic Maternofoetal Transmission and Prevention of Diabetes Susceptibility-1)

“…Male F2 offspring of STZ treated pregnant grandmothers (n = 18) -Male F2 offspring of untreated pregnant grandmothers (n = 8) Interestingly enough, a significant lower prevalence rate (1/3) of infantile-onset diabetics, who were born during this period, was found in Berlin, Halle and Leipzig than in the other districts of the GDR (Dörner et al, 1985). 7.…”

“…A significantly decreased prevalence rate (less than 1/3) was found for juvenile-onset diabetics who were born in a low-caloric war and post-war period -with an apparently low incidence rate of gestational diabetes -as compared to those of similar age who were born in a high-caloric peace period with an apparently high incidence rate of gestational diabetes (Dörner and Mohnike, 1973;Dörner et al, 1985).…”

Perinatal Hyperinsulinism and Perinatal Obesity as Risk Factors for Hyperinsulinaemia in Later Life

“…Persistent hyperinsulinaemia is known again as an essential predisposing factor to type II and type I diabetes (Dörner et al, 1988 and1990) as well as to cardiovascular disease (Lautala et al, 1985;Fontbonne et al, 1988;Zavaroni et al, 1989). Hence, it is comprehensible that by prevention of pre-and perinatal hyperinsulinism -induced by maternal hyperglycaemia during pregnancy -and of perinatal obesity -induced by overnutrition -a successful genuine prophylaxis of diabetes mellitus (Dörner et al, 1984(Dörner et al, , 1985 could and of cardiovascular disease (Fujimoto et al, 1987a, b) may be achieved.…”