The “Pre‐diabetic” Period from an Obstetric Point of View

Childbearing Prior to Recognition of Diabetes: Recollected Birth Weights and Stillbirth Rate in Babies Born to Parents Who Developed Diabetes

“…It does not agree with the reports of several authors, 21 -27 but is in very close accord with that of Herzstein and Dolger 22 and not significantly different from that of Hagbard. 10 If it is accepted that stillbirth is only in excess of normal during the five-year period before the diagnosis, the question arises whether this period in fact represents the delay in diagnosis of early cases. Stillbirth might then be a manifestation of clinical diabetes and not a "prediabetic" event.…”

“…Others have found that fetal loss is not abnormal prior to this five-year period. 10 ' 22 The objects of the present study were, first, to compare the recollected birth weights of the children of diabetic men and women in the years before diabetes was recognized with those of a control group and to determine whether the tendency to produce very large babies, if confirmed, increases as the diagnosis of diabetes approaches and, secondly, to make the same observations with regard to stillbirths in the case of women.…”

Some Aspects of Carbohydrate Metabolism in Pregnancy With Special Reference to the Energy Metabolism and Hormonal Status of the Infant of the Diabetic Woman and the Diabetogenic Effect of Pregnancy

“…While it seems clear that many of these so-called ' prediabetic ' women have shown relatively minor degrees of hyperglycaemia, at least during pregnancy many years before the diagnosis of clinical diabetes (Hagbard, 1958;Hagen, 1961;Lunell, 1966;Kalkhoff, Richardson & Stoddard, 1968), not all cases can be explained on this basis, and other metabolic, constitutional and probably inherited factors are almost certainly involved in the production of the big baby. While it seems clear that many of these so-called ' prediabetic ' women have shown relatively minor degrees of hyperglycaemia, at least during pregnancy many years before the diagnosis of clinical diabetes (Hagbard, 1958;Hagen, 1961;Lunell, 1966;Kalkhoff, Richardson & Stoddard, 1968), not all cases can be explained on this basis, and other metabolic, constitutional and probably inherited factors are almost certainly involved in the production of the big baby.…”

Infants of mothers with a high and of mothers with a low insulin response to glucose infusion. Glucose tolerance, insulin response and clinical appearance during the early neonatal period

“…This is different from what has been reported for insulin and k-value in adults [16,30] and in 3 Discussion older chüdren ^5], suggesting that the k-value Women who deliver large or malformed i n normal newborn infants is normally more babies have been reported to run a higher risk influenced by factqrs other than the insulin than others of developing clinical or chemical response. MÖLSTEDT-PEDERSEN and JÖRGEN-diabetes mellitus later on [13,17,22]. However, S E N [21] found a positive correlation between these observations were not based on studies of these two factors, but they measured the insulin the carbohydrate tolerance during pregnancy, at a later stage (12 min after the glucose injection) and the occurrence of a transient gestational an d their group also included 50 per cent of diabetes might have passed unnoticed.…”

“…Diabetes mellitus in a pregnant woman affects the development of the fetal pancreas [2] resulting in hyperinsulinism of the newborn infant who also often presents typical clinical traits [8,23,32], Furthermore, diabetic women may produce large-for-date infants long before their disturbed carbohydrate metabolism is diagnosed [13,17]. It is not known, however, at which stage in the development of diabetes this effect on the fetus appears.…”