Hyperinsulinemia and macrosomia
Article Abstract:
Delivery of a large infant, macrosomia, is related to the presence of diabetes in pregnant women. Studies that analyze infant umbilical cord serum for maternal sources of insulin have been used to determine the relationship between maternal and neonatal blood glucose concentrations. In the August 2, 1990 issue of The New England Journal of Medicine substantial evidence is given for the maternal-fetal transfer of insulin leading to hyperinsulinemia and macrosomia. The transfer of nutrients from mother to fetus stimulated pancreatic insulin secretion in the fetus and had direct metabolic effects. The investigators propose that the insulin administered to the mothers was transferred to the infants and contributed to hyperinsulinemia and macrosomia. Furthermore, hyperinsulinemia is found in infants of mothers with diabetes who had not received insulin, concentrations of insulin in amniotic fluid is elevated, concentrations of free insulin in umbilical blood are increased, and the protein, C peptide is present in amniotic fluid and umbilical blood. The consequences of hyperinsulinemia in infants are independent of the insulin source. It was previously believed that insulin administered to pregnant women did not cross the placenta; however the evidence is now available. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: The New England Journal of Medicine
Subject: Health
ISSN: 0028-4793
Year: 1990
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Premature birth and later insulin resistance
Article Abstract:
The theory that insulin resistance, a marker of type 2 diabetes mellitus, would be prevalent among children who were prematurely born, irrespective of whether they were appropriate for gestational age or small for gestational age is explored. It is concluded that like children who were born at term but who were small for gestational age, children who were born prematurely have an isolated reduction in insulin sensitivity, which may be a risk factor for type 2 diabetes mellitus.
Publication Name: The New England Journal of Medicine
Subject: Health
ISSN: 0028-4793
Year: 2004
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