The status of diabetic embryopathy

Abstract

Diabetic embryopathy is a theoretical enigma and a clinical challenge. Both type 1 and type 2 diabetic pregnancy carry a significant risk for fetal maldevelopment, and the precise reasons for the diabetes-induced teratogenicity are not clearly identified. The experimental work in this field has revealed a partial, however complex, answer to the teratological question, and we will review some of the latest suggestions.

Keywords: Anomalies; development; diabetes in pregnancy; epigenetics; gene expression; malformations.

Figure 1.

Two day-9 rat embryos from a normal (left embryo) and a diabetic (right embryo) pregnancy. The latter embryo is growth-retarded (reduced crown-rump length and somite number) and malformed (rotational defect, open neural tube).

Figure 2.

Schematic outline of the development of diabetic embryopathy. Blue color marks increased activity/amount, and red color decreased or disturbed activity/amount of compounds or processes. Note that more interactions between the items are likely to be present than those denoted here, and that the putative importance of genetic predisposition is not included.