Summary
Serum concentrations of glucose, C-peptide, IRI (Immunoreactive insulin) and proinsulin were determined in 31 insulin-dependent diabetic mothers and their newborn infants and in 13 nondiabetic mothers and their babies at the time of delivery. Eleven mothers with long-term diabetes had insulin antibodies and low or undetectable C-peptide levels (mean ± SEM: 0.04±0.01 nmol/l). Diabetic mothers without insulin antibodies had a mean C peptide value of 1.18 nmol/1 (range 0.05–3.00) and the non-diabetics 0.95 nmol/l (0.28–2.4). Blood glucose values (2 to 4 hours after birth) of less than 1.7 mmol/l were observed in 7 of the 11 babies with antibodies and in 3 of the 20 babies without antibodies. C-peptide in the 31 babies of diabetic mothers correlated to maternal glucose (p < 0.05). In addition the mean glucose value (2–4 hours) was negatively correlated to IRI and proinsulin (p < 0.01) in the babies without antibodies, confirming that elevated maternal glucose leads to increased insulin secretion at the time of birth, which may lead to hypoglycaemia. In babies without antibodies birth weight correlated to their C-peptide (p < 0.01) and proinsulin (p < 0.01). The 31 babies of the diabetic mothers were born with higher C-peptide (1.01±0.16 nmol/ 1) than babies of non-diabetic mothers (0.39±0.04 nmol/1). The newborn infants secrete significantly more proinsulin than their mothers. Babies of mothers with insulin antibodies were born with the same concentrations of antibodies (Pearson correlation coefficient = 0.98) as in their mothers, but total IRI was higher in these babies, due in part to human proinsulin being bound to the antibodies. There were significant correlations between insulin antibodies on the one hand, and IRI, proinsulin and C-peptide on the other, in the 11 babies, p < 0.001, p < 0.001 and p < 0.01, respectively, the last indicating increasing B-cell activity with higher antibody levels.
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Spellacy WN, Goetz FC (1963) Insulin antibodies in pregnancy. Lancet II: 222–224
Jørgensen KR, Deckert T, Mølsted-Pedersen L, Pedersen J (1966) Insulin, insulin antibody and glucose in plasma of newborn infants of diabetic women. Acta Endocrinol (Kbh) 52: 154–167
Starzyńska R, Seniow S, Kodejszko E, Kowalski H, Starzynski S, Depowska B (1969) Studies on the transport of insulin antibodies across the placenta to the fetus and their effect on the fetal pancreatic islet system. Acta Diabetol Lat 6: 573–584
Persson B (1975) Treatment of diabetic pregnancy. Isr J Med Sci 11: 609–616
Block MB, Pildes RS, Mossabhoy NA, Steiner DF, Rubenstein AH (1974) C-peptide immunoreactivity (CPR): A new method for studying infants of insulin-treated diabetic mothers. Pediatrics 53: 923–928
Phelps RL, Freinkel N, Rubenstein AH, Kuzuya H, Metzger BE, Boehm JJ, Mølsted-Pedersen L (1978) Carbohydrate metabolism in pregnancy. XV. Plasma C-peptide during intravenous glucose tolerance in neonates from normal and insulin-treated diabetic mothers. J Clin Endocrinol Metab 46: 61–68
Persson B, Gentz J, Lunell NO (1978) Diabetes in pregnancy. In: Scarpelli EM, Cosmi EV (eds) Reviews in perinatal medicine, vol 2. Raven Press, New York, p 1–55
Persson B, Feychting H, Gentz J (1975) Management of the infant of the diabetic mother. In: Sutherland HW, Stowes JM (eds) Carbohydrate metabolism in pregnancy and the newborn. Livingstone, Edinburgh, p 232–248
Christiansen AaH (1973) Radioimmunoelectrophoresis in the determination of insulin binding to IgG. Methodological studies. Horm Metab Res 5: 147–154
Heding LG (1972) Determination of total serum insulin (IRI) in insulintreated diabetic patients. Diabetologia 8: 260–266
Heding LG (1975) Radioimmunological determination of human C-peptide in serum. Diabetologia 11: 541–548
Heding LG (1977) Specific and direct radioimmunoassay for human proinsulin in serum. Diabetologia 13: 467–474
Martin FIR (1976) Absolute neonatal insulin levels in children of insulin-requiring diabetic patients. Am J Obstet Gynecol 125: 71–72
Stimmler L, Brazie JV, O'Brien D (1964) Plasma-insulin levels in the newborn infants of normal and diabetic mothers. Lancet I: 137–138
Thomas K, de Gasparo M, Hoet JJ (1967) Insulin levels in the umbilical vein and in the umbilical artery of newborns of normal and gestational diabetic mothers. Diabetologia 3: 299–304
François R, Picaud JJ, Ruitton-Ugliengo A, David L, Cartal MJ, Bauer D (1974) The newborn of diabetic mothers. Biol Neonate 24: 1–31
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Heding, L.G., Persson, B. & Stangenberg, M. B-cell function in newborn infants of diabetic mothers. Diabetologia 19, 427–432 (1980). https://doi.org/10.1007/BF00281821
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DOI: https://doi.org/10.1007/BF00281821