Insulin Metabolism and Pregnancy

Afternoon Glucose Tolerance Testing: A Key to the Pathogenesis, Early Diagnosis and Prognosis of Diabetogenic Hyperinsulinism

“…Although speculative, the antigenicity of excessive endogenous insulin may incite increased antithyroid antibody formation as well as the elaboration of insulin‐binding protein. The skin reactivity to crystalline insulin found in diabetic patients (including those who have never received insulin) and the absence of such skin reactivity in nondiabetic controls prompted the cautious suggestion by Arkins, Engbring and Lennon (70) that “endogenous insulin might on occasion incite an autoimmune response.” Pettit, Landing and Guest (71) suggested the following simple explanation for their finding of a high incidence of antithyroid antibody in juvenile diabetics: “The biochemical dysfunction of the thyroid gland leading to autoimmunization is an inherent component of hereditary diabetes mellitus, but is far overshadowed clinically by dysfunction of the pancreatic islets.”…”

Banting Lecture 1980: of Pregnancy and Progeny

“…4 With the development of insulin immunoassays, such measurements soon became available. Spellacy and Goetz, 22 Kalkhoff et al, 23 and Bleicher, O'Sullivan, and Freinkel 24 independently reported that insulin secretion in response to glucose is increased in late human pregnancy.…”

“…Clinical experience indicated that the latter period was especially noteworthy for its diabetogenic propensities (see ref. 4 for review of temporal characteristics). Thus, coincident with the marked growth of the conceptus, insulin requirements of diabetics increase, diabetic tendencies of previously unknown diabetics become unmasked, and the hypoglycemic potency of insulin is diminished as insulin resistance supervenes.…”

Some aspects of placental functionThis forms part of a thesis submitted to the University of London for the degree of Doctor of Philosophy.

“…But the discrepancies may be explained by other observations for it appears that in the rat and the human, insulin accumulates in the placenta and is degraded (Freinkel and Goodner, 1962;Buse, Roberts and Buse, 1962). It is also questionable whether the foetal tissues are mature enough to respond to insulin.…”