Background: Diabetes in pregnancy affects fetal growth and development. The insulin/insulin-like growth factors (IGF) system comprising insulin, IGF, their receptors, and binding proteins, has been implicated in fetal growth regulation. This study tested the hypothesis that maternal diabetes alters the fetal insulin/IGF system in a tissue-specific manner. Methods: Wistar rats were rendered diabetic by neonatal administration of streptozotocin and mated with control rats. At day 21 of gestation, the weights of fetuses, placentas, and fetal organs (heart, lung, liver, stomach, intestine, and pancreas) were determined. Maternal and fetal plasma concentrations of insulin, IGF1, and IGF2 were measured by ELISA, and expression of IGF1, IGF2, IGF1R, IGF2R, IR, IGFBP1, BP2, and BP3 in placenta and fetal organs by qPCR. results: The well-known increase in fetal growth in this model of mild diabetes is accompanied by elevated insulin and IGF1 levels and alterations of the insulin/IGF system in the fetus and the placenta. These alterations were organ and gene specific. The insulin/IGF system was generally upregulated, especially in the fetal heart, while it was downregulated in fetal lung. conclusion: In our model of mild diabetes, the effect of maternal diabetes on fetal weight and fetal insulin/IGF system expression is organ specific with highly sensitive organs such as lung and heart, and organs that were less affected, such as stomach. d iabetes in pregnancy, i.e., the fetal exposure to hyperglycemia in utero, has become recognized as a risk factor for immediate adverse pregnancy outcome, and in having longterm effects on mother and offspring. Immediate outcomes include excessive fetal fat accretion as well as congenital malformations, such as cardiac, musco-skeletal, and central nervous system anomalies (1,2). Early evidence in Pima Indians and in animal models has clearly shown that long-term effects of growing in a diabetic environment in utero include a higher risk for the offspring to develop obesity, type 2 diabetes (T2D), the metabolic syndrome, and cardiovascular disease later in life (3). This was confirmed in further studies in which offspring from diabetic pregnancies were followed up into adolescence (4).One of the well-known effects of the diabetic environment on the offspring is its growth promoting action as reflected by weight increases of the fetus proper and of some fetal tissues (5,6). The insulin/IGF system is a potent regulator of development and growth, and elevated levels of cord blood insulin can be regarded as hallmark of fetal changes in the wake of maternal diabetes (7,8). This system comprises insulin, the insulin-like growth factors-1 (IGF1) and -2 (IGF2), the receptors for insulin (IR), IGF1 (IGF1R) and IGF2 (IGF2R) as well as a range of binding proteins (IGFBP1-6) for both IGFs, which regulate IGF bioavailability by modulating the half-life of IGFs and their site of action (9). Only a small proportion of IGFs circulates in a free form, the bulk is bound to IGFbinding proteins (IGFBPs). Am...