Studies of Abnormal Carbohydrate Metabolism in Pregnancy: The Significance of Impaired Glucose Tolerance

Wilkerson, Hugh L. C.; Remein, Quentin R.

doi:10.2337/diab.6.4.324

Cited by 70 publications

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“…1 Wilkerson studied the glucose tolerance in a large series of pregnant women. 2 In those instances where he observed abnormal carbohydrate tolerance during pregnancy, he found that newborns weighing nine pounds or more occurred three times as frequently as in the group with normal carbohydrate tolerance.Lazarow reported that subdiabetes in rats could be produced by injecting subthreshold doses of alloxan. 8 Although these rats had an abnormal tolerance to glucose, their fasting and postprandial blood sugars were normal.…”

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Birth Weight and Fetal Mortality in Pregnant Subdiabetic Rats

1960

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It has been reported that diabetic women frequently give histories of fetal overweight and of increased fetal mortality in pregnancies occurring many years before the development of manifest diabetes. 1 Wilkerson studied the glucose tolerance in a large series of pregnant women. 2 In those instances where he observed abnormal carbohydrate tolerance during pregnancy, he found that newborns weighing nine pounds or more occurred three times as frequently as in the group with normal carbohydrate tolerance.Lazarow reported that subdiabetes in rats could be produced by injecting subthreshold doses of alloxan. 8 Although these rats had an abnormal tolerance to glucose, their fasting and postprandial blood sugars were normal. They did not show any glycosuria.In two thirds of these animals, subdiabetes persisted for a period up to a year and more. One third of these animals developed manifest diabetes (hyperglycemia and glycosuria) during the first year.The present study was undertaken to determine whether pregnant subdiabetic rats likewise show a high incidence of stillborns and overweight newborns. METHODSThe animals used were albino rats of a subline of the Sprague-Dawley strain (Holtzman). Most of the rats were virgin females, 120 to 150 days in age, weighing between 230 and 280 gm. The rats were fed a standard diet of Purina fox chow. Food and water were supplied ad libitum. The experimental and control animals were maintained under similar conditions. Production of subdiabetes: Alloxan was dissolved in distilled water to make a 2 or 4 per cent solution immediately prior to injection. Nonpregnant females were injected intravenously with alloxan in a dose of 25 or 30 mg. per kg. of body weight (Lazarow and Palay). 4 A few rats were injected with alloxan on the twelfth day of pregnancy. Those rats which did not show either ĥ yperglycemia or glycosuria were subjected to glucose tolerance tests. Animals were fasted sixteen to eighteen hours and injected intravenously with a 30 per cent glucose solution in a dose of 3 gm. per kg. of body weight. Blood sugars (BS) were determined by the Folin-Malmros micromethod. 5 The diabetic index (I D ) which is a measure of the degree of abnormality of glucose tolerance was determined for each test, using the following formula (Coupland, Davidson and Lazarow). 6 _ t hr. experimental BS 2 hr. experimental BS 1 hr. average normal BS 2 hr. average normal BS In forty-two tolerance tests carried out in twelve normal rats, the average one-and two-hour blood sugar values were 175.2 and 111.9 mg. per cent, respectively, and those values were used in calculating the diabetic index. The index determined in normal rats equals 1.00 plus or minus the standard deviation of 0.30 (Coupland, Davidson, and Lazarow). 7 All fourteen subdiabetic rats had diabetic indices greater than 2.0, i.e., more than three standard deviations greater than normal. In eleven of the rats used, subdiabetes was induced prior to pregnancy; in three, subdiabetes was induced on the twelfth day of pregnancy. Since the averag...

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Birth Weight and Fetal Mortality in Pregnant Subdiabetic Rats

1960

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“…Recent careful analyses by Cardell26 (on autopsy material) and Farquhar2 (in live children and their families) have indicated that there is no excessive anomaly rate in'the off spring of diabetics. Hoet et al28 claim to have found a distinctly abnormal glucose tolerance curve in 22 per cent. of the mothers of 50 children with severe congenital malformation.…”

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confidence: 96%

“…3a). I Since 1952, the results of several series of oral glucose tolerance tests in suspected prediabetics have been reported.,6 19,21,22,71,72 Of course a number of previously unsuspected, definite diabetics have been discovered, whose sugar tolerance curve no one would deny as being grossly abnormal. Some were found without glycosuria, even during pregnancy, despite blood sugar levels in the three hundreds.…”

Section: Summary Of Implications Of Prediabetesmentioning

confidence: 99%

“…Despite this, and the rather remarkable constancy of the abnormalities on repetition of the test, many authorities at first would not believe that such minor changes in tolerance as shown by 2or 24-hour levels could be meaningful.73 The validity of such a belief, however, has since been vindicated by follow-up studies which have demonstrated the appearance of overt diabetes in many of those whose earlier tolerance curves had been so slightly abnormal. 22,65,74,75 It must not be supposed that abnormal curves will be found in the majority of women who have produced large babies or stillbirths. For one thing prediabetes or diabetes is only one cause of these phenomena, and secondly many women, even though prediabetic, may have completely normal tolerance curves, especially if they are tested when not pregnant.…”

Section: Summary Of Implications Of Prediabetesmentioning

confidence: 99%

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