Insulin-anti-insulin complexes in diabetic women and their neonates

Abstract

It is known that insulin does not cross placenta, whereas maternal anti-insulin antibodies do. We have therefore investigated insulin antibodies and insulin-anti-insulin complexes both in pregnant diabetic women during pregnancy and in umbilical cord blood from their new-born infants. Forty-seven diabetic pregnant women and 23 new-born-infants of these diabetic women were studied. All the pregnant patients were studied at the end of pregnancy and in 27, at least on one other occasion during pregnancy. All the patients were treated with insulin during pregnancy: 26 had Type 1 (insulin-dependent) diabetes, 14 Type 2 (non-insulin-dependent) diabetes and seven had gestational diabetes. Insulin antibodies were found in 62% of the Type 1 diabetic patients, in 71% of the Type 2 diabetic patients and in 43% of the gestational diabetic patients. There were present in 48% of the infants studied. Insulin-anti-insulin complexes were found in 37% of the women with Type 1 diabetes, in 21% of those with Type 2 diabetes and in 14% of those with gestational diabetes. Complexes were found in 38% of the new-born infants. The presence of these complexes in the babies was more strongly correlated with their occurrence in their mothers at the beginning than at the end of pregnancy. Insulin-anti-insulin complexes are thus present in the neonatal circulation. They may differ from those in their mothers and they may have pathophysiological and clinical importance.

Autoantibodies to Insulin Are Present in Sera of Patients With Autoimmune Thyroid Disease

“…Insulin autoantibodies are known to occur spontaneously in patients without a prior history of insulin injections, and furthermore, insulin-binding antibodies frequently occur before the onset of type I diabetes (7,(17)(18)(19). Wilkin et al (8) reported that 38% of newly diagnosed type I diabetic subjects and 47% of their unaffected identical twins had insulinbinding autoantibodies.…”

Jet-Injected Insulin Is Associated With Decreased Antibody Production and Postprandial Glucose Variability When Compared With Needle-Injected Insulin in Gestational Diabetic Women

“…Such bound insulin may interfere with fetal insulinglucose homeostasis (2). GDM provides an opportunity to study women without previous exposure to insulin.…”

Autoimmunity and familial risk of type 1 diabetes

“…It has been proposed that IAs may induce abnormal insulin secretion and pancreatic insulitis in the fetus and newborn infant. Insulin-IA-complexes may be detected in the circulation of newborn infants; previously, these were thought to play a role in neonatal hypoglycemia [12]. More recently, Dozio et al [14] found no correlation between IAs and neonatal events.…”

“…It has been shown that IA levels in women with type 1 diabetes remain quite stable during pregnancy [11,12] or decrease only slightly toward term [13,14]. At the time of delivery, it has been shown that around 74% to 90% of mothers with type 1 diabetes are IA-positive [15,16].…”