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Query: UMLS:C0011849 (diabetes)
 277,896 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Serial human placental lactogen (H.P.L.) determinations were carried out in 98 diabetic women during the third trimester of pregnancy. H.P.L. levels were consistently higher than those in normal pregnant women. When patients were classified according to the severity of their diabetes (White classification), no significant differences in H.P.L. were detected between groups. Changes in blood-sugar during the day did not affect H.P.L. readings, and insulin requirements during pregnancy could not be related to H.P.L. levels. 10 pregnancies ended in fetal death, and in 4 of them H.P.L. levels were persistently below 4 mug. per ml. Of these 4 infants only 1, whose intrauterine death remains unexplained, could have been saved, 2 having fatal malformations and another infant having died during an episode of maternal ketoacidosis. Among the 6 unsuccessful pregnancies in which H.P.L. levels were greater than 4 mug. per ml., congenital malformations accounted for 5 losses and hyaline-membrane disease for a single neonatal death. These results indicate that H.P.L. determinations probably have a very limited role in the successful management of diabetic pregnancy.
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PMID:Serial determinations of human placental lactogen in the management of diabetic pregnancy. 4 51

Urinary estriol, serum placental lactogen (hPL), and alphafetoprotein (AFP) levels were investigated in singleton pregnancies of 75 diabetic women and 84 women with obstetric hepatosis. Fetal distress was demonstrated in 19 diabetic patients (25%) and in 18 cases of obstetric hepatosis (21%). Low urinary estriol correctly predicted fetal distress in 26% of the cases of diabetes and in 29% of the cases of hepatosis. False pathologic readings were found in 9% of pregnancies in either group. Diabetes was associated with higher than normal hPL levels with overlap of levels between cases with fetal distress and normal outcome. hPL levels were higher than normal and correctly predicted fetal distress in 2 of 18 cases of hepatosis (11%) with no false pathologic values. In diabetes, AFP predicted fetal distress in 2 of 4 cases in which a subsequent perinatal death occurred, and 1 additional case of fetal distress. False pathologic values were found in 4% of cases. Maternal AFP levels were normal in 2 cases of closed neural tube anomalies. In cases of hepatosis, AFP gave no information. In combination, estriol and AFP determinations gave correct information in 35% of diabetic pregnancies with pernatal morbidity or death. In hepatosis, estriol and hPL pointed out 33% of the cases of fetal distress.
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PMID:Prediction of fetal outcome by urinary estriol, maternal serum placental lactogen, and alpha-fetoprotein in diabetes and hepatosis of pregnancy. 6 7

To determine the potential of an artificial pancreatic beta cell simulator as a therapeutic and research tool we have used the device for short-term monitoring and control of blood glucose concentrations in five pregnant patients with juvenile-onset diabetes (White's Class C) and three pregnant patients with maturity-onset diabetes (Class B). One patient with brittle juvenile-onset diabetes had successful control before, during, and after cesarean section. The other seven patients were studied during the third trimester of pregnancy and at least four weeks before delivery. Blood glucose control with Biostator regulation was excellent (mean, 96 mg. per deciliter; range, 85 to 107). The insulin requirements needed to achieve optimal glucose control with the Biostator were highly variable (range, 20 to 157 U. per 24 hours) but very similar to those previously calculated to provide optimal control by conventional means. Insulin requirements were unrelated to plasma growth hormone, placental lactogen, or glucagon concentrations. The greatest degree of insulin resistance was seen in obese patients with endogenous insulin-secretory capacity. This study indicates that a pancreatic beta cell simulator can normalize glucose concentrations and rapidly estimate daily insulin requirements in pregnant diabetic patients. In addition, the data suggest that exogenous insulin may indirectly suppress endogenous insulin secretion and thus contribute to the "insulin resistance" of obese patients with maturity-onset diabetes.
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PMID:Studies with a pancreatic beta cell simulator in the third trimester of pregnancies complicated by diabetes. 70 88

Toxemia of pregnancy was associated with an elevation of the pregnancy-associated plasma protein (PAPP)-A concentration, as compared to the level in normal pregnancy in the last month of gestation. The other pregnancy proteins measured were not altered in toxemia. In twin pregnancies, the PAPP-A, PAPP-C, and human placental lactogen levels were all increased, particularly PAPP-A. On the other hand, pregnancy zone protein was not affected by twinning. Pregnancy with diabetes showed normal levels of these proteins.
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PMID:Plasma concentrations of four pregnancy proteins in complications of pregnancy. 87 49

Intravenous glucose tolerance tests were performed on 30 primigravidae with pre-eclampsia and 15 normal primigravidae in late pregnancy. The groups were matched for age, height and weight and had no stigmata of potential diabetes. Plasma glucose, plasma immunoreactive insulin and plasma placental lactogen (HPL) levels were measured before (fasting) and at timed intervals after the glucose challenge; the glucose response was expressed as the increment index. The patients with severe pre-eclampsia had significantly lower fasting plasma glucose levels than those with mild pre-eclampsia and normal pregnancies. The mean increment index in both the severe and mild pre-eclamptic groups was significantly lower than that of the normal pregnant group. Fasting HPL levels were significantly lower in patients with severe pre-eclampsia than in those who had mild pre-eclampsia or a normal pregnancy. Both the fasting plasma insulin and insulin response following glucose injection were lower in patients with severe pre-eclampsia than in those with mild pre-eclampsia or a normal pregnancy. The differences however were not statistically significant. The results of this study suggest that carbohydrate metabolism in severe pre-eclampsia is altered to an extent similar to that in patients with chemical gestational diabetes, and this alteration may be due to maternal beta-cell anoxia caused by the vascular changes in pre-eclampsia.
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PMID:Carbohydrate metabolism in pre-eclampsia. 103 12

The plasma levels of human placental lactogen (HPL) in healthy and in diabetic pregnant Natal Indians were studied. The plasma HPL pattern in the control group was similar to that recorded in the literature and reconfirmed the increase in HPL during normal pregnancy. The plasma HPL of the pregnant diabetics was usually within 1 standard deviation of the mean normal value for that duration of pregnancy. HPL excess could not be incriminated as a cause for the disturbed metabolism in the women with diabetes.
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PMID:Placental lactogen in pregnant Natal Indian diabetic patients. 127 13

Amniotic fluid (AF) and maternal serum (MS) chorionic gonadotropin (HCG), placental lactogen (HPL), pregnancy-specific beta 1-glycoprotein (SP1), total estrogens (ET), alpha-fetoprotein (AFP) and prolactin (PRL) were measured by enzyme-immunoassays, in 50 normal (A) and in 37 abnormal (B) pregnancies, from 16th to 40th weeks. A: the proteins HCG, AFP and PRL showed a similar decreasing trend after the 20th week, while HPL and SP1 rose progressively throughout the 2nd trimester, thereafter remaining constant. On the contrary ET showed an increasing pattern until term. Chorionic gonadotropin HPL and SP1 in MS were higher than in AF, while AF values of AFP and PRL were higher than in MS, but the ratio MS/AF of all hormone values increased significantly from the 2nd to the 3rd trimester (p < 0.005-p < 0.000001). Estrogens had about the same concentration in AF and MS during the 2nd trimester, but at term of pregnancy, their AF values were double those of MS. B: in polyhydramnios, elevated AF placental hormones were found, while PRL was very low. In erythroblastosis and diabetes, AFP was very low, but placental hormones, PRL and ET were both high and low. In toxemia, SP1, hCG and PRL were elevated, while HPL and ET were very low. In anencephaly and hydrocephaly with spina bifida, AFP was markedly elevated and ET were very low, but in simple hydrocephalus, very low AFP was found. In chromosomal anomalies very high placental hormones and very low AFP and ET were found.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Amniotic fluid hormone profiles during normal and abnormal pregnancy. 128 May 39

Pregnancy is a state of natural insulin resistance, which is due to placental production of human placental lactogen (HPL), an insulin antagonising hormone, leading to a remarkable increase of insulin requirement in pregnant diabetics in the 2nd and 3rd trimester. Aim of the prospective study was the quantification of daily insulin requirement during the last 28 days before delivery in pregnant women suffering from insulin-dependent diabetes mellitus (n = 20) with and without evidence of "placental insufficiency syndrome" employing peripheral rheography as indirect parameter for placental haemoperfusion. All diabetic women included controlled carbohydrate metabolism by means of a functional insulin therapy (FIT; HbA1c in normal range < 5.8%), a multiple injection regime with frequent blood glucose self-control at least from the 2nd trimester of pregnancy. According to the results of peripheral rheography in the 34th gestational week, an impedanceplethysmographic method for quantifying peripheral haemoperfusion, patients were subdivided in a group with (B: n = 8) and without (A: n = 12) indirect evidence of placental dysfunction. Groups did not differ in maternal age, duration of diabetes, maternal weight and week of delivery (A: 39.08 +/- 1.44; B: 39.12 +/- 1.46). Mean weight of neonates was lower in group B (3319 +/- 619 g) compared to group A (3613 +/- 437 g). During a comparable state of near-normoglycaemia in both groups, 7 out of 8 women in group B, but only 1 out of 12 women in group A displayed a significant decrease in daily insulin requirement from day -28 to day -3 before delivery (linear regression; p < 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Monitoring daily insulin needs--an important follow-up parameter in late pregnancy in diabetic mothers?]. 129 34

Placentas associated with maternal diabetes are generally characterized by features of villous immaturity. We correlated the villous histology with the immunocytochemical distribution of four trophoblastic proteins: beta human chorionic gonadotropin (beta HCG), placental alkaline phosphatase (PLAP), pregnancy specific beta-1-glycoprotein (SP1), and human placental lactogen (HPL) in 14 third-trimester placentas associated with diabetes mellitus. Staining was increased for beta HCG and decreased for PLAP, SP1, and HPL in the diabetic placentas compared to control placentas of similar gestational age. This pattern was most prominent in areas of marked architectural villous immaturity within individual placentas and suggests concomitant functional immaturity.
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PMID:Placental protein distribution in maternal diabetes mellitus: an immunocytochemical study. 248 1

Serum progesterone, oestradiol, human chorionic gonadotrophin (hCG) and human placental lactogen (hPL) were determined serially throughout 27 pregnancies in insulin-dependent diabetic patients from Newcastle (UK), 15 such patients from Stockholm (Sweden) and in 69 normal women having uncomplicated pregnancies. Mean progesterone, oestradiol and hCG concentrations were somewhat higher in the diabetic women during the third trimester but hPL values were not different from normal. The increased hormone concentrations did not relate to the increased birthweights or placental weights in the diabetic women. It is suggested that the usual physiological endocrine changes during normal pregnancy are relatively undisturbed by insulin-dependent diabetes or the degree of diabetes control achieved.
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PMID:A longitudinal study of circulating progesterone, oestradiol, hCG and hPL during pregnancy in type 1 diabetic mothers. 275 54


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