Effects on rat embryos of culture in serum of women with gestational diabetes.
Serum from diabetic patients, as well as having high levels of glucose and ketone bodies, is known to have embryotoxic and teratogenic effects that play an important role in diabetes-induced teratology. We studied the effect of serum from women with gestational diabetes, who are not known to have a high incidence of malformations in their offspring, on the in vitro development of 10.5-day-old rat embryos. Results from these studies were then compared with those using serum from pregnant women with Type I diabetes, serum from pregnant women without diabetes, and normal rat serum. Serum from pregnant women with Type I diabetes caused abnormalities in 71% of the embryos in comparison with an incidence of 53.3% in embryos cultured in serum from women with gestational diabetes. Embryos cultured in serum from women without diabetes or in rat serum had a 9 and 4.2% incidence of defects, respectively. Diabetic serum also decreased the size of the embryos, the number of somites, yolk sac diameter, and the amount of protein in the embryos and their yolk sacs. This damage was more significant when embryos were cultured in Type I diabetic serum than in serum from patients with gestational diabetes. The levels of serum glucose, glycosylated haemoglobin, fructosamine, beta-hydroxybutyrate (beta-HOB) and acetoacetate were also higher in Type I diabetic serum than in serum from gestational diabetes. Significant ultrastructural damage was observed in the yolk sacs of embryos cultured in diabetic serum, with a reduction in the endocytic index. The fact that serum from women with gestational diabetes is teratogenic to early somite rat embryos supports the hypothesis that metabolic factors are responsible for diabetes-induced teratogenicity and that to prevent these defects it is essential to stabilize the diabetic state of the mother before, and during, early gestation.
Ornoy
A
A
Laboratory of Teratology, Department of Anatomy and Embryology, The Hebrew University-Hadassah Medical School, Jerusalem, Israel.
Zaken
V
V
Abir
R
R
Yaffe
P
P
Raz
I
I