Maternal serum placental growth factor and fetal SGA in pregnancy complicated by type 1 diabetes mellitus

Most women with type 1 diabetes mellitus (T1DM) have increased insulin requirements during pregnancy. However, a minority of women have a fall in insulin requirements. When this occurs in late gestation, it often provokes concern regarding possible compromise of the feto-placental unit. In some centres, this is considered as an indication for delivery, including premature delivery. There are, however, many other factors that affect insulin requirements in pregnancy in women with type 1 diabetes mellitus and the decline in insulin requirements may represent a variant of normal pregnancy. If there is no underlying pathological process, expedited delivery in these women is not warranted and confers increased risks to the newborn. We will explore the factors affecting insulin requirements in gestation in this review. We will also discuss some novel concepts regarding beta-cell function in pregnancy.

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Managing type 1 diabetes mellitus in pregnancy—from planning to breastfeeding

Nature Reviews Endocrinology ◽

10.1038/nrendo.2012.154 ◽

2012 ◽

Vol 8 (11) ◽

pp. 659-667 ◽

Cited By ~ 33

Author(s):

Lene Ringholm ◽

Elisabeth R. Mathiesen ◽

Louise Kelstrup ◽

Peter Damm

Keyword(s):

Diabetes Mellitus ◽

Type 1 Diabetes ◽

Type 1 Diabetes Mellitus ◽

In Pregnancy

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Serum Concentrations of Transforming Growth Factor-Beta 1 in Predicting the Occurrence of Diabetic Retinopathy in Juvenile Patients with Type 1 Diabetes Mellitus

Journal of Diabetes Research ◽

10.1155/2013/614908 ◽

2013 ◽

Vol 2013 ◽

pp. 1-6 ◽

Cited By ~ 18

Author(s):

Katarzyna Zorena ◽

Ewa Malinowska ◽

Dorota Raczyńska ◽

Małgorzata Myśliwiec ◽

Krystyna Raczyńska

Keyword(s):

Diabetes Mellitus ◽

Type 1 Diabetes ◽

Diabetic Retinopathy ◽

Growth Factor ◽

Type 1 Diabetes Mellitus ◽

Transforming Growth Factor Beta ◽

Transforming Growth Factor ◽

Serum Concentrations ◽

Growth Factor Beta

In the present study, we have decided to evaluate if serum transforming growth factor-beta 1 (TGF-β1) concentrations may have diagnostic value in predicting the occurrence of diabetic retinopathy (DR) in juvenile patients with type 1 diabetes mellitus (T1DM). The study included 81 children and adolescents with T1DM and 19 control subjects. All study participants had biochemical parameters examined, underwent an eye examination, and 24-hour blood pressure monitoring. Moreover, serum concentrations of TGF-β1 were measured. The group of patients with T1DM and nonproliferative diabetic retinopathy (NPDR) had statistically significant higher serum levels of TGF-β1 (P=0.001) as compared to T1DM patients without retinopathy as well as the healthy control subject. The threshold serum TGF-β1 concentrations which had a discriminative ability to predict the presence of DR were calculated using the receiver operating characteristic (ROC) curves analysis and amounted to 443 pg/ml. The area under the ROC curve (AUCROC) was 0.80, and its population value was in the range of 0.66 to 0.94. The sensitivity and specificity were calculated to be 72% and 88%, respectively. Our results suggest that TGF-β1 serum concentrations may be an additional parameter in predicting the occurrence of DR in juvenile patients with T1DM.

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