Spontaneous abortion among insulin-dependent diabetic women

Miodovnik, Menachem; Lavin, Justin P.; Knowles, Harvey C.; Holroyde, Jane; Stys, Stanley J.

doi:10.1016/s0002-9378(84)80141-6

Cited by 122 publications

(21 citation statements)

References 9 publications

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“…(Diamond et al, 1987), it appears that institution of strict metabolic control during the earliest periods after fertilization is needed to preserve normal development. The consequences of failure to achieve this metabolic state are observable in vitro; the in-vivo correlates remain to be established, but may cause the early pregnancy losses described by Miodovnik et al (1984Miodovnik et al ( , 1985Miodovnik et al ( , 1986.…”

Section: Discussionmentioning

confidence: 99%

“…Several reports have suggested a direct correlation between the degree of metabolic control and the occurrence of spontaneous miscarriages in dia¬ betic women (Miodovnik et al, 1984(Miodovnik et al, , 1985(Miodovnik et al, , 1986), but such relationships remain controversial (Pedersen, 1977;Kitzmiller et al, 1978;Kalter, 1985). Additionally, in women (Parsons et al, 1926) and other animals (Chieri et al, 1969), poor metabolic control is associated with anovulation, while fPresent address: Department of Obstetrics and Gynecology, Washington University School of Medicine, St Louis, MO 63110,USA. insulin therapy restores ovarian cyclicity.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Effects of streptozotocin- and alloxan-induced diabetes mellitus on mouse follicular and early embryo development

Diamond¹,

Moley²,

Pellicer³

et al. 1989

Reproduction

107

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Mice were made diabetic by intraperitoneal injection of streptozotocin or alloxan. Germinal vesicle breakdown in the ovarian follicles at 8 h after hCG in control animals (57%) was significantly greater than in streptozotocin-(24%) and alloxan\x=req-\ (42%) diabetic animals (P < 0\m=.\001). This delay in oocyte maturation was reversible by in-vivo insulin administration to diabetic mice. A developmental delay was also found for embryos recovered from diabetic mice. This developmental delay extended into the 72 h in-vitro cultures. Compared to control embryos, those from alloxan-and streptozotocin-treated mice demonstrated marked impairment in development as assessed by (1) distribution of developmental cell stages at each observation period and (2) rates of development which increasingly diverged at each observation period.In diabetic mice treated with insulin in vivo, the percentage of 2-cell embryos recovered increased. Furthermore, in streptozotocin-and alloxan-animals treated with insulin, the rate of in-vitro development of embryos, as well as their developmental stage distribution improved. We therefore suggest that uncontrolled diabetes mellitus, as well as contributing to the development of congenital malformations, may deleteriously affect reproductive performance both before fertilization and at the very earliest gestational stages.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Effects of streptozotocin- and alloxan-induced diabetes mellitus on mouse follicular and early embryo development

Diamond¹,

Moley²,

Pellicer³

et al. 1989

Reproduction

107

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“…Those high-risk HLA haplotypes were found more frequently in type 1 diabetic children diagnosed under the age of 5 years than in those diagnosed when older (24,25). One study, which included early spontaneous abortions using a sensitive ␤-chain human chorionic gonadotropin radioimmunoassay for the detection of pregnancy before clinical detection, reported that the age at onset of diabetes is associated with the risk of spontaneous abortions (20). The rate of spontaneous abortions was the highest, 45%, if mother's "White class" was D, where the age at onset of diabetes is Յ10 years.…”

Section: Transmission Of Type 1 Diabetesmentioning

confidence: 99%

Differential Transmission of Type 1 Diabetes from Diabetic Fathers and Mothers to Their Offspring

Harjutsalo¹,

Reunanen

Tuomilehto

2006

Diabetes

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We studied the incidence of type 1 diabetes in the offspring of patients with childhood-and adolescent-onset type 1 diabetes and several risk factors predicting the risk. We defined the diabetes status in the offspring of all probands who were included in the nationwide register of Finnish type 1 diabetic patients diagnosed at the age of <17 years from 1965 T he incidence of childhood type 1 diabetes has increased globally over the past decades (1,2). The risk of type 1 diabetes in the offspring of diabetic parents by the age of 20 years is ϳ4 -5%, depending on the population where the studies have been conducted and differences in the study design (3-7). It has been suggested that the increase in the incidence of type 1 diabetes has been more rapid in the offspring of type 1 diabetic patients than in the background population (3).The sex difference in the recurrence risk of type 1 diabetes has been detected by a number of studies: the offspring of the fathers who were affected with type 1 diabetes have an increased risk for type 1 diabetes compared with the offspring of affected mothers (3,4,6,8). Preferential cross-sex transmission has also been detected by some studies (3,9) but not by others (4,8).Large, population-based studies with optimal study design are sparse where the ascertainment of offspring is through diabetic parents and complete. Our aim was to assess the recurrence risk of type 1 diabetes in the offspring of a Finnish population-based cohort of patients with childhood-and adolescence-onset type 1 diabetes. We also investigated possible sex-related effects in the transmission of type 1 diabetes from the diabetic parents to their offspring. In addition, we were able to study temporal trends in the incidence during 1970 -2003 and characterize several variables that might have influenced the recurrence risk of type 1 diabetes in the offspring. RESEARCH DESIGN AND METHODSWe defined the diabetes status of all offspring of all probands who are included in the nationwide register of Finnish cases with type 1 diabetes diagnosed before age of 18 years between 1965 and 1979 (n ϭ 5,144). The cohort was originally used in the Diabetes Epidemiology Research International (DERI) mortality study (10,11). Briefly, the register was initially based on the central drug register (CDR) of the Social Insurance Institution, including patients approved to receive free-of-charge medication for certain diseases including diabetes. The case ascertainment in this cohort was virtually complete (12,13). Their offspring and the other parent of the offspring were identified through the national population register by computer linkage using the unique personal identifier that is assigned to all residents of Finland. The offspring were mainly born between 1970 and 2001, only four of them before 1970. The diabetes status of the offspring was ascertained through several sources: from the nationwide Hospital Discharge Register for years 1970 -2003, from the nationwide Finnish Diabetes Register for children and young adults, and f...

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“…Regardless of what the cause, hyperglycemia in mothers translates into hyperglycemia in the fetus, which is a potent teratogen [4,5]. Poorly controlled blood glucose immediately prior to pregnancy can lead to major birth defects in 5% to 10% of pregnancies, and spontaneous abortion in 40% of pregnancies [4][5][6]. Maternal complications associated with uncontrolled blood glucose are many.…”

Section: Highlights Of the Management Of Diabetes In Pregnancymentioning

confidence: 99%

Insulin Pumps in Pregnancy: Using Technology to Achieve Normoglycemia in Women with Diabetes

et al. 2011

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Poorly controlled diabetes before conception and during pregnancy among women with pre-existing diabetes can cause major birth defects and spontaneous abortions, as wells as abnormal fetal growth and development including an offspring who is small or large for gestational age, or predisposed to obesity, type 2 diabetes, and metabolic syndrome in his/her lifetime. Conversely, for a woman with pre-existing diabetes, optimizing blood glucose levels before and during early pregnancy can reduce these risks dramatically. As insulin pump technology has evolved, continuous subcutaneous insulin infusion has become a safe and reliable method for treating diabetes during pregnancy. Although pump therapy is often preferred by patients and some experts, insulin pumps have not yet been shown to be superior to multiple daily injections of insulin during pregnancy. In this review of the literature we focus on the use of insulin pumps in the management of diabetes in pregnancy.

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Spontaneous abortion among insulin-dependent diabetic women

Cited by 122 publications

References 9 publications

Effects of streptozotocin- and alloxan-induced diabetes mellitus on mouse follicular and early embryo development

Effects of streptozotocin- and alloxan-induced diabetes mellitus on mouse follicular and early embryo development

Differential Transmission of Type 1 Diabetes from Diabetic Fathers and Mothers to Their Offspring

Insulin Pumps in Pregnancy: Using Technology to Achieve Normoglycemia in Women with Diabetes

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