A role for gestational diabetes in the excess maternal transmission of type 2 diabetes?
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Adult↗
Biomedical subjects
T Harder
Publications and source records attributed to T Harder.
Cholecystokinin-8S levels in discrete hypothalamic nuclei of weanling rats exposed to maternal protein malnutrition.
Perinatal malnutrition and growth retardation at birth are suggested to be important risk factors for the development of overweight and syndrome X in later life. Underlying mechanisms are unknown. Body weight and food intake are regulated, e.g. by hypothalamic neuropeptidergic systems which are thought to be highly vulnerable to persisting malorganization due to perinatal malnutrition. To investigate possible consequences for hypothalamic cholecystokinin-8S (CCK-8S) in the offspring, pregnant Wistar rats were fed an 8% protein diet during pregnancy and lactation (low-protein group; LP) while control mothers (CO) received a 17% protein isocaloric standard diet. LP offspring displayed underweight at birth (P < 0.05) and during suckling (P < 0.001), while leptin levels were not altered. At weaning, under basal conditions CCK-8S was decreased in LP offspring in the paraventricular hypothalamic nucleus and arcuate hypothalamic nucleus (P < 0.05), as well as in the dorsomedial hypothalamic nucleus, lateral hypothalamic area and ventromedial hypothalamic nucleus (P < 0.01). In summary, these data indicate (1) an inhibition of the satiety peptide CCK-8S in main regulators of body weight and food intake in low-protein malnourished newborn rats; (2) no direct relationship of hypothalamic CCK-8S to circulating leptin at this age; and (3) no neurochemical signs of hypothalamic CCKergic dysregulation in this animal model at the age of weaning.
Animals↗
Elevation of hypothalamic neuropeptide Y-neurons in adult offspring of diabetic mother rats.
We recently reported on an elevation of neurons expressing the main orexigenic peptide neuropeptide Y (NPY) in the arcuate hypothalamic nucleus (ARC) of neonatally hyperinsulinaemic offspring of gestational diabetic mother rats (GD) at weaning. To investigate possible consequences, the long-term outcome of those animals was examined. At adult age, GD offspring showed hyperphagia (p < 0.001), basal hyperinsulinaemia (p < 0.05) and impaired glucose tolerance (p < 0.05), and were overweight (p < 0.01). This was accompanied by an elevated number of NPY neurons (p < 0.001) and galanin neurons (p < 0.001) in the ARC in adult GD offspring under basal conditions. These findings support our hypothesis on perinatally acquired, persisting malformation and/or malprogramming of peptidergic hypothalamic neurons in the offspring of GD mothers, possibly promoting the development of overweight and diabetogenic disturbances during life.
Animals↗
Analysis of CD44-containing lipid rafts: Recruitment of annexin II and stabilization by the actin cytoskeleton.
CD44, the major cell surface receptor for hyaluronic acid (HA), was shown to localize to detergent-resistant cholesterol-rich microdomains, called lipid rafts, in fibroblasts and blood cells. Here, we have investigated the molecular environment of CD44 within the plane of the basolateral membrane of polarized mammary epithelial cells. We show that CD44 partitions into lipid rafts that contain annexin II at their cytoplasmic face. Both CD44 and annexin II were released from these lipid rafts by sequestration of plasma membrane cholesterol. Partition of annexin II and CD44 to the same type of lipid rafts was demonstrated by cross-linking experiments in living cells. First, when CD44 was clustered at the cell surface by anti-CD44 antibodies, annexin II was recruited into the cytoplasmic leaflet of CD44 clusters. Second, the formation of intracellular, submembranous annexin II-p11 aggregates caused by expression of a trans-dominant mutant of annexin II resulted in coclustering of CD44. Moreover, a frequent redirection of actin bundles to these clusters was observed. These basolateral CD44/annexin II-lipid raft complexes were stabilized by addition of GTPgammaS or phalloidin in a semipermeabilized and cholesterol-depleted cell system. The low lateral mobility of CD44 in the plasma membrane, as assessed with fluorescent recovery after photobleaching (FRAP), was dependent on the presence of plasma membrane cholesterol and an intact actin cytoskeleton. Disruption of the actin cytoskeleton dramatically increased the fraction of CD44 which could be recovered from the light detergent-insoluble membrane fraction. Taken together, our data indicate that in mammary epithelial cells the vast majority of CD44 interacts with annexin II in lipid rafts in a cholesterol-dependent manner. These CD44-containing lipid microdomains interact with the underlying actin cytoskeleton.
Actins↗
Perinatal elevation of hypothalamic insulin, acquired malformation of hypothalamic galaninergic neurons, and syndrome x-like alterations in adulthood of neonatally overfed rats.
Overnutrition during critical developmental periods is suggested to be a risk factor for obesity and associated metabolic disorders in later life. Underlying mechanisms are unknown. Neuropeptides are essentially involved in the central nervous regulation of body weight. For instance, hypothalamic galanin (GAL) is a stimulator of food intake and body weight gain. To investigate long-term consequences of early postnatal overfeeding, the normal litter size of Wistar rats (n=10; controls) was reduced from day 3 to day 21 of life to only 3 pups per mother (small litters, SL; overnutrition). Throughout life, SL rats displayed hyperphagia (p<0.01), overweight (p<0.0001), hyperinsulinemia (p<0.01), impaired glucose tolerance (p<0.001), elevated triglycerides (p<0.001), and an increased systolic blood pressure (p<0.05). In adulthood, an increase of GAL-neurons in the arcuate hypothalamic nucleus (ARC) was found (p<0.001), positively correlated to body weight (p<0.001). A second experiment revealed hyperinsulinemia (p<0.001) and increased hypothalamic insulin levels (p<0.05) in SL rats during early postnatal life. Already on day 21 of life, i.e., at the end of the critical hypothalamic differentiation period, in SL rats the number of GAL-neurons was increased in the ARC (p<0.001), showing a positive correlation to body weight and insulin (p<0.05). In conclusion, neonatally acquired persisting malformation of hypothalamic galaninergic neurons, induced by early overfeeding and hyperinsulinism, might promote the development of overweight and syndrome X-like alterations during life.
Animals↗
Increased number of galanin-neurons in the paraventricular hypothalamic nucleus of neonatally overfed weanling rats.
Perinatal overfeeding is a risk factor for overweight and diabetes during life. Underlying pathophysiological mechanisms are unclear. The peptide galanin is suggested to stimulate food intake by acting within the paraventricular hypothalamic nucleus (PVN). In early postnatally overfed rats overweight and hyperinsulinemia were observed, accompanied by an increased number of galanin-positive neurons in the PVN at weaning. Our results might indicate malformation of hypothalamic galaninergic neurons due to neonatal overfeeding and hyperinsulinism, respectively, in rats.
Animals↗
Clusters of glycolipid and glycosylphosphatidylinositol-anchored proteins in lymphoid cells: accumulation of actin regulated by local tyrosine phosphorylation.
Lateral cross-linking of glycosylphosphatidylinositol (GPI)-anchored proteins and glycosphingolipids can trigger a signaling cascade which leads to activation of lymphoid cells. A possible explanation how the signal is transduced through the plasma membrane has arisen from the concept of raft sphingolipid-cholesterol microdomains in cell membranes. Cross-linking of GPI-anchored proteins, glycolipids and other raft components leads to the formation of stabilized membrane patches in the plasma membrane which enrich members of the Src-tyrosine kinase family. We have studied cellular responses to raft patch formation in the Jurkat T cell line and in particular changes in the actin cytoskeleton. We found that raft patches formed by GPI-anchored CD59 protein and the ganglioside GM1 accumulate filamentous actin. Most interestingly, we observed a strong accumulation of tyrosine-phosphorylated proteins in raft patches, strongly supporting the view that they can function as centers of signal transduction. Using a Lck kinase-deficient variant of Jurkat cells and a specific Lck and Fyn tyrosine kinase inhibitor we found that enrichment of actin in raft patches is dependent on phosphotyrosine accumulation in the patches. These observations show a link between raft-mediated signaling and the interaction of actin cytoskeleton with raft membrane domains.
Actins↗
Morphological alterations of hypothalamic nuclei due to intrahypothalamic hyperinsulinism in newborn rats.
In former studies, a temporary, intrahypothalamically localized hyperinsulinism during brain development was shown to result in overweight and metabolic disturbances during later life in rats. Therefore, we tested the hypothesis whether intrahypothalamic insulin treatment during early postnatal life may lead to hypothalamic morphological alterations, i.e., of numerical density of neurons and area of neuronal nuclei or area of neuronal cytoplasm, in this animal model. For this purpose, on the 8th day of age in Wistar rats a long-acting insulin was bilaterally applicated stereotactically into the hypothalamus (12 mIU on each side), while in controls the insulin-free agar-vehicle was given only. By computer-assisted morphometric analysis on the 15th day of life a decrease of the mean area of neuronal nuclei and the mean nucleus-cytoplasm-ratio within the VMN of the insulin-treated animals was observed, as compared to control rats (P < 0.05), while no significant alterations were found in the lateral hypothalamic area (LHA). Analysis of topographically distinct parts of the VMN revealed significant reductions of the mean area of neuronal nuclei (P < 0.001) and nucleus-cytoplasm-ratio (P < 0.05) in the anterior part of the VMN (VMNpa). Furthermore, in the ventrolateral part (VMNpv) a decreased mean neuronal density was observed in the insulin group (P < 0.01). In contrast, the dorsomedial part of the VMN (VMNpd) displayed an increased mean neuronal density in the insulin-treated animals (P < 0.05). In the dorsomedial hypothalamic nucleus (DMN) a significant increase of the mean area of neuronal nuclei (P < 0.01) and the area of neuronal cytoplasm were observed (P < 0.001). These alterations were accompanied by a significantly elevated mean numerical density of astrocytes (positive for glial fibriallary acidic protein; GFAP+) within the periventricular hypothalamic area (PER) of the insulin-treated rats (P < 0.05). These observations speak for a varying vulnerability of LHA, DMN and distinct parts of the VMN to hyperinsulinism during early development, possibly leading to a disturbed organization and, consecutively, permanent dysfunction of these morphologically connected and functionally interacting hypothalamic nuclei.
Animals↗
Observations on the orexigenic hypothalamic neuropeptide Y-system in neonatally overfed weanling rats.
Early postnatal overnutrition is a risk factor for obesity in juvenile and adult life. Underlying pathophysiological mechanisms are still unclear. Hypothalamic neuropeptides are decisively involved in the regulation of body weight and food intake. In this study, we investigated consequences of early postnatal overnutrition, as compared to normo-and undernutrition, on NPY within the arcuate nucleus and paraventricular nucleus (PVN). The normal litter size of Wistar rats was adjusted on the third day of life from 10 pups (normal litters, NL; normonutrition) to only three newborns (small litters, SL; overnutrition) or 18 pups per mother (large litters, LL; undernutrition). SL rats developed clear overweight until the day 21 of life (P<0.0001), as well as hyperleptinaemia (P<0.001), and hyperinsulinaemia (P<0.01). LL rats were underweight and had decreased leptin and insulin concentrations. Using radioimmunoassay, NPY contents were determined in hypothalamic micropunches, and immunocytochemistry for NPY was performed in serial hypothalamic sections on day 21 of life. While in the underweight, hypoleptinaemic, and hypoinsulinaemic LL rats increased concentrations of NPY in the arcuate nucleus and PVN were observed, no decrease in NPY content was found in the overweight, hyperleptinaemic, and hyperinsulinaemic SL rats. Moreover, the percentage of NPY-immunopositive neurones per total number of neurones was increased not only in the LL rats, but also in the SL rats. Since the NPY system is functionally mature already at this age, these findings might indicate an acquired resistance of the hypothalamic NPY system to increased levels of insulin and/or leptin in early postnatally overfed SL rats.
Animals↗
Malformations of hypothalamic nuclei in hyperinsulinemic offspring of rats with gestational diabetes.
Insulin is a potent modulator of central nervous development and is suggested to influence the differentiation and maturation of hypothalamic structures involved in the regulation of body weight and metabolism. Hyperinsulinemic offspring of mothers with impaired glucose tolerance during pregnancy (gestational diabetes, GD) have an increased risk to develop overweight and diabetes mellitus during life, while the underlying pathophysiological mechanisms are still unknown. To investigate the effects of perinatal hyperinsulinism on the organization of hypothalamic regulators of body weight and metabolism, GD was induced in rats by application of streptozotocin on the day of conception (25 mg/kg, i.p.). On the 21st day of life, offspring of GD rats were overweight (p < 0.05) and hyperinsulinemic (p < 0.01). Using computer-assisted morphometric measurements, significantly decreased mean areas of neuronal nuclei and neuronal cytoplasm within the paraventricular hypothalamic nucleus (PVN; p < 0.01) and the ventromedial hypothalamic nucleus (VMN; p < 0.05) were observed in GD offspring. Analysis of topographically distinct parts revealed that these alterations particularly occurred in the parvocellular part of the PVN, as well as in the anterior, central, and dorsomedial part of the VMN. No morphometric alterations were found within the lateral hypothalamic area and the dorsomedial hypothalamic nucleus. In the arcuate hypothalamic nucleus, the mean area of neuronal cytoplasm was decreased (p < 0.05), while the number of neurons expressing tyrosine hydroxylase was clearly elevated (p < 0.002). For astrocytes, a tendency towards an increased glia/neuron ratio was observed in the periventricular hypothalamic area. These observations suggest disturbed differentiation and organization of distinct hypothalamic nuclei and subnuclei, respectively, in hyperinsulinemic offspring of GD rats, possibly leading to dysfunctions of hypothalamic regulators of body weight and metabolism which might contribute to the lifelong increased risk to develop overweight and diabetogenic disturbances.
Animals↗
Overweight and increased diabetes susceptibility in neonatally insulin-treated adult rats.
OBJECTIVE: Since the offspring of gestational diabetic mothers (GD) is at increased risk to develop obesity and diabetogenic disturbances later in life, while pathophysiological mechanisms responsible are unclear, to investigate long-term consequences of neonatal hyperinsulinism occurring characteristically in GD offspring. METHODS: Newborn Wistar rats received daily subcutaneous injections of a long-acting insulin from the 8th to 11th day of life (IRI), while in controls (CO) NaCl was applied. Body weight was recorded throughout life. Glucose tolerance test was performed on the 140th day of life (1.5 g/kg glucose injected i.p. after an overnight fast and blood samples were taken up to 90 min from retroorbital plexus). On the 240th day of life, the vulnerability to a single "subdiabetogenic" dose of streptozotocin (STZ; 25 mg/kg body weight) was tested. Blood samples for estimating glucose levels were taken before STZ, and subsequently on days 2, 7, 14, 21, and 28 after STZ. RESULTS: IRI rats developed overweight during juvenile life until adulthood (P<0.001), characterized by a clear elevation of the Lee obesity index (P<0.005), and associated with basal hyperglycaemia (P<0.05), hyperinsulinaemia (P<0.05), as well as an increased insulin/glucose-ratio as a measure of insulin resistance (P<0.005). Impaired glucose tolerance occurred in early adulthood, and increased vulnerability to a "subdiabetogenic" dose of streptozotocin (see above), leading to significant hyperglycaemia (P<0.05), was evaluated in the 9th month of age. Accompanied by a transient reduction of hyperinsulinaemia during a period of 21 days, Lee obesity index and insulin/glucose-ratio decreased significantly after STZ treatment in IRI rats (P<0.01). CONCLUSIONS: Overweight and increased diabetes susceptibility in adulthood due to temporary hyperinsulinism during a critical period of postnatal life are suggested to be a consequence of acquired dysregulation and overstimulation, respectively, of the pancreatic insulin secretion in rats.
Analysis of Variance↗
Hypothalamic insulin and neuropeptide Y in the offspring of gestational diabetic mother rats.
The offspring of diabetic mothers is at increased risk to develop obesity and diabetogenic disturbances during life. Pathophysiological mechanisms responsible are unclear. Neuropeptide Y (NPY) is an important hypothalamic stimulator of food intake and body weight gain, and its levels are decreased by elevated insulin. In neonatally hyperinsulinaemic offspring of diabetic mother rats, hypothalamic insulin level was significantly increased at birth (p < 0.01). At weaning, i.e. at the end of the critical hypothalamic differentiation period, a significantly increased number of NPY-positive neurons (p < 0.01) appeared in the arcuate hypothalamic nucleus. In conclusion, an increase in the number of NPYergic neurons in the hypothalamus, possibly due to hypothalamic malformation and/or perinatally acquired hypothalamic insulin resistance, might contribute to the development of obesity and metabolic disturbances in the offspring of diabetic mothers.
Animals↗
Reduction of cholecystokinin-8S-neurons in the paraventricular hypothalamic nucleus of neonatally overfed weanling rats.
Cholecystokinin (CCK) is suggested to be involved, e.g. in the central nervous modulation of food intake, possibly by acting within specific hypothalamic nuclei. Perinatal overnutrition predisposes to permanent obesity and hyperphagia, while underlying mechanisms are unclear. By reducing the litter size from the 3rd to 21st day of life, early overnutrition was induced in newborn rats. At weaning, clear overweight (P < 0.001), hyperglycaemia (P < 0.05), hyperinsulinaemia (P < 0.001), and insulin resistance (P < 0.001) occured. These early signs of obesity were associated with a significantly decreased number of CCK-positive neurons in the paraventricular hypothalamic nucleus (P < 0.002). In conclusion, due to neonatal overfeeding malformation of CCKergic neurons at the end of the critical hypothalamic differentiation period occurs. Long-term consequences on CCK-related neuroendocrine regulations could be suggested, including those affecting food intake and body weight gain.
Animals↗
Alterations of hypothalamic catecholamines in the newborn offspring of gestational diabetic mother rats.
Catecholamines are essential organizers of the developing brain. Throughout life, they are involved, e.g., in the regulation of body weight and metabolism by specific hypothalamic nuclei, which are suggested to be highly vulnerable to maternal gestational hyperglycemia. By application of streptozotocin (30 mg/kg, i.p.) gestational diabetes (GD) was induced in female rats. On the 1st day of life, male GD offspring were underweight (P<0.05) and hyperglycemic (P<0.05), while on the 21st day of life decreased body weight (P<0.001) and elevated pancreatic insulin (P<0.01) were observed. Using HPLC with electrochemical detection, hypothalamic catecholamines were determined in the newborns, and quantitative immunocytochemistry for tyrosine hydroxylase (TH) was performed. At birth, a tendency towards increased levels of norepinephrine (NE) and dopamine (DA) in the whole hypothalami of GD offspring was observed. In the 21-day-old offspring of GD mothers, NE was significantly increased in the ventromedial hypothalamic nucleus (VMN; P<0.05) and the lateral hypothalamic area (LHA; P<0.05), while DA was significantly elevated in the paraventricular hypothalamic nucleus (PVN; P<0.05) and the LHA (P<0.05). The NE/DA-ratio was found to be decreased in the PVN of GD offspring (P<0.01). Moreover, numerical density of TH-positive neurons was clearly increased within the parvocellular division of the PVN (P<0.0001) as well as in the periventricular hypothalamic area (PER; P<0.05). These data suggest specific alterations of catecholaminergic systems within hypothalamic regulators of body weight and metabolism during early development in the offspring of gestational diabetic mother rats.
Animals↗
Age-related muscle atrophy does not affect all muscles and can partly be compensated by physical activity: an ultrasound study.
In adults, the volume of quadriceps femoris muscle decreases with age, whereas the impact of increasing age on the size of other extremity muscles was hardly studied. This study was conducted to examine whether age-related muscle atrophy is a general phenomenon, whether it is accompanied by increasing subcutaneous fat and whether physical activity can compensate age-related muscle atrophy. One hundred and two female and 101 male subjects (aged 19-86 years), with common physical activity, as well as 29 women and 38 men (aged 20-81 years) regularly performing sports at least 3 h per week for several years (mean, 10 years in women and 14 years in men, respectively), were examined. Both in athletes and control subjects, the thickness of thigh muscles significantly decreased with age (-15(-)-21% from age 20 to age 70), whereas diameter of upper arm muscles remained nearly unchanged. Diameters of the calf muscle decreased with advancing age only in the control group. In male control subjects, the tibialis anterior muscle shrunk as well. Except for the vastus lateralis muscle in women, the relative loss of muscle thickness was more evident in control subjects than in athletes. Thickness of the subcutaneous fat layers remained almost unchanged. In summary, not all extremity muscles exhibit age-related decrease in size. Regular physical activity can ease off muscle atrophy.
Adipose Tissue↗
Lipid domain structure of the plasma membrane revealed by patching of membrane components.
Lateral assemblies of glycolipids and cholesterol, "rafts," have been implicated to play a role in cellular processes like membrane sorting, signal transduction, and cell adhesion. We studied the structure of raft domains in the plasma membrane of non-polarized cells. Overexpressed plasma membrane markers were evenly distributed in the plasma membrane. We compared the patching behavior of pairs of raft markers (defined by insolubility in Triton X-100) with pairs of raft/non-raft markers. For this purpose we cross-linked glycosyl-phosphatidylinositol (GPI)-anchored proteins placental alkaline phosphatase (PLAP), Thy-1, influenza virus hemagglutinin (HA), and the raft lipid ganglioside GM1 using antibodies and/or cholera toxin. The patches of these raft markers overlapped extensively in BHK cells as well as in Jurkat T-lymphoma cells. Importantly, patches of GPI-anchored PLAP accumulated src-like protein tyrosine kinase fyn, which is thought to be anchored in the cytoplasmic leaflet of raft domains. In contrast patched raft components and patches of transferrin receptor as a non-raft marker were sharply separated. Taken together, our data strongly suggest that coalescence of cross-linked raft elements is mediated by their common lipid environments, whereas separation of raft and non-raft patches is caused by the immiscibility of different lipid phases. This view is supported by the finding that cholesterol depletion abrogated segregation. Our results are consistent with the view that raft domains in the plasma membrane of non-polarized cells are normally small and highly dispersed but that raft size can be modulated by oligomerization of raft components.
Alkaline Phosphatase↗
Syndrome X-like alterations in adult female rats due to neonatal insulin treatment.
Hypothalamic structures are decisively involved in the regulation of body weight and metabolism. In syndrome X, complex metabolic alterations are present, which in women are found to be associated with disturbances of reproductive function and altered androgen levels. In previous experiments in rats, it was shown that a temporary intrahypothalamic hyperinsulinism during early life predisposes to overweight and diabetogenic disturbances later in life, associated with disorganization of hypothalamic regulatory centers. To investigate the possible long-term consequences of elevated peripheral insulin levels during ontogenesis, the following experiment was performed. Newborn female Wistar rats were treated during neonatal life with daily subcutaneous injections of long-acting insulin ([IRI group] 0.3 IU on days 8 and 9 of life and 0.1 IU on days 10 and 11 of life), whereas control animals (CO) received daily NaCl injections. This temporary exposure to increased insulin levels during a critical developmental period resulted in an increased body weight gain including juvenile life and adulthood (P < .01), accompanied by hyperinsulinemia (P < .01), impaired glucose tolerance (P < .05), and increased systolic blood pressure in adulthood (P < .025). No significant alterations were detected either in cyclicity and fertility or in the levels of testosterone, androstenedione, or dehydroepiandrosterone (DHEA) in IRI rats. Morphometric evaluation of hypothalamic nuclei showed a reduced numerical density of neurons (P < .025) and a decreased neuronal volume density (P < .025) within the ventromedial hypothalamic nucleus (VMN) of the IRI rats, whereas the antagonistic lateral hypothalamic area (LHA) was morphometrically unchanged. Newborn offspring of IRI rats (F1 generation) were overweight (P < .05) and had an increased pancreatic insulin concentration (P < .02). In conclusion, perinatal hyperinsulinism seems to predispose to the later development of syndrome X-like changes in female rats, possibly due to impaired organization of hypothalamic regulators of body weight and metabolism.
Animals↗
Glucose tolerance and insulin secretion in children of mothers with pregestational IDDM or gestational diabetes.
The offspring of mother's with diabetes mellitus during pregnancy are presumed to develop altered glucose homeostasis. We analysed metabolic parameters at birth and glucose tolerance and insulin secretion during oral glucose tolerance tests at 1-9 years of age in 129 children born to mothers with pregestational insulin-dependent diabetes (IDDM) and 69 infants of gestational diabetic mothers. Newborns of IDDM mothers displayed higher insulin (p < 0.001), glucose (p < 0.05), and insulin/glucose ratios (p < 0.002) than newborns of gestational diabetic mothers. During childhood, frequencies of impaired glucose tolerance (IGT) rose in infants of IDDM mothers from 9.4% at 1-4 years to 17.4% at 5-9 years of age, while in children of gestational diabetic mothers an increase from 11.1% up to 20.0% was observed. Offspring of gestational diabetic mothers displayed higher stimulated blood glucose (p < 0.025) than infants of IDDM mothers, while children of IDDM mothers showed higher stimulated insulin (p < 0.025), accompanied by increased fasting and stimulated insulin/glucose ratios (p < 0.05 and p < 0.02, respectively). Stimulated insulin in childhood was positively correlated to insulin at birth (p < 0.05). Furthermore, insulin/glucose ratio in childhood showed a positive correlation to insulin (p < 0.01) and insulin/glucose ratio at birth (p < 0.005). In conclusion, a pathogenetic role of fetal and neonatal hyperinsulinism for the development of IGT in both groups of infants of diabetic mothers is suggested, in particular for early induction of insulin resistance in the offspring of mothers with pregestational IDDM.
Birth Weight↗