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Biomedical subjects

M Stangenberg

Publications and source records attributed to M Stangenberg.

49 records · Page 3Linked to original sources
PubMed1984

Amniotic fluid C-peptide and phosphatidyl glycerol in diabetic pregnancy.

The concentrations of C-peptide and phosphatidylglycerol in the amniotic fluid were determined in 36 pregnant diabetic women. Twenty-one patients who were being treated with insulin for gestational diabetes as well as 15 patients who were insulin dependent were studied. All patients were subjected to a program of strict metabolic control, and amniocentesis was performed at gestational week 36-37. Phosphatidyl glycerol was present in the amniotic fluid in 15 cases and absent in 21. The mean concentration of C-peptide did not differ whether phosphatidyl glycerol was present or absent. (C-peptide: 0.56 +/- 0.06 and 0.43 +/- 0.05 nmol/l respectively). Although the mean value for amniotic fluid C-peptide in both groups was close to that in diabetic pregnancies with an uneventful neonatal outcome, it was significantly higher than that in non-diabetic pregnancies, indicating minor fetal hyperinsulinemia. The level of C-peptide in the amniotic fluid showed a correlation to the subsequent birthweight of the infant (r = 0.50; p less than 0.01). It is concluded that with rigorous metabolic control of the pregnant diabetic patient, the presence or absence of phosphatidyl glycerol, as an index of fetal lung maturity, is apparently not related to the level of C-peptide in the amniotic fluid.

Amniocentesis↗
PubMed1984

Spiral artery lesions in relation to metabolic control in diabetes mellitus.

Decidual and intramyometrial spiral arteries from 18 insulin-dependent diabetic and 18 non-diabetic women were compared histologically. All women were normotensive and none had signs of pre-eclampsia. None of the infants in either group had intra-uterine growth retardation. Metabolic control in the diabetic women was assessed by pregnancy glucose level from the last trimester of pregnancy and by C-peptide in amniotic fluid and cord blood as a measure of the fetal beta-cell function. The intramyometrial and decidual parts of the spiral artery were normal in the non-diabetic group. None of the diabetic patients showed pathological changes in the intramyometrial part of the spiral artery. Two of the 18 diabetic patients had pathological changes (intramural fibrosis) in the decidual portion of the spiral artery. These two women had signs of diabetic angiopathy (White's class D and F) and in one of them, the background diabetic retinopathy progressed markedly during pregnancy. The pregnancy glucose level was above normal (greater than 6.2 mM/l) in 3 of 18 diabetics. The C-peptide values in amniotic fluid and cord blood were above normal in 11 of 17 and in 5 of 17, respectively. Both patients with spiral artery lesions had pregnancy glucose levels in the upper range, 5.86 and 5.98 mM/l, respectively and the highest value of C-peptide in the amniotic fluid and cord blood, suggesting exaggerated fetal beta-cell function.

Adult↗
PubMed1984

Fetal maturation in strictly controlled diabetic pregnancy.

In 56 strictly controlled diabetic pregnancies, altogether 60 amniotic fluid samples were analysed for their content of lipid-carrying cells and the presence of phosphatidylglycerol. The outcome of the amniotic fluid tests was examined for its association to macrosomia and to minor neonatal complications such as hypoglycaemia, hypocalcaemia, respiratory disturbances and hyperbilirubinaemia. The predictive value of these tests was nil, since all cases of neonatal complications occurred in the group showing maturity in tests at week 37. At term, phosphatidylglycerol was detected in 80% of the pregnancies, a finding corresponding to our observations in non-diabetic pregnancies. Lipid-carrying cells were present in quantities indicating maturity (greater than or equal to 10%) in 65% of the pregnancies at term, compared with 87% in non-diabetic pregnancies, suggesting a somewhat disturbed skin maturation secondary to the maternal diabetic state. The failure of these tests to predict neonatal complications indicates that other factors may be of more importance for the occurrence of these disorders than those aspects of final functional maturation of the fetus that are reflected in these two particular maturity tests.

Adult↗
PubMed1983

Insulin-induced hypoglycemia in pregnant diabetics. Maternal and fetal cardiovascular reactions.

Insulin (0.1 IU/kg bw) was injected intravenously in 9 pregnant diabetics in the last trimester of pregnancy. Maternal levels of blood glucose, estriol, human placental lactogen, blood pressure and pulse rate were measured and fetal heart rate (FHR) recorded. During hypoglycemia maternal blood pressure remained unchanged but maternal pulse rate tended to increase. Plasma levels of estriol and HPL remained unchanged. In 6 of the 9 patients there was a decrease in FHR variability during the hypoglycemic period. FHR variability increased after normalization of maternal blood glucose levels. The decrease in FHR variability could be a direct effect of glucopenia on the fetal heart.

Adult↗
PubMed1982

Fetal beta cell function in diabetic pregnancy. Amniotic fluid concentrations of proinsulin, insulin, and C-peptide during the last trimester of pregnancy.

Proinsulin, insulin C-peptide, insulin-binding antibody, and glucose concentrations were measured in amniotic fluid samples from 43 insulin-treated diabetic patients and 17 nondiabetic control patients between the thirty-six and thirty-ninth weeks of gestation. Insulin-binding antibodies in amniotic fluid were present in only three diabetic patients, although antibodies in maternal serum were found in 22 of the diabetic subjects. In the diabetic group, maternal serum insulin-binding antibodies were statistically unrelated to levels of C-peptide in amniotic fluid. The mean amniotic fluid concentrations of proinsulin (0.07 nmole/L), insulin (0.08 nmole/L), C-peptide (1.17 nmoles/L), and glucose (2.09 mmoles/L) were markedly elevated (p less than 0.001) in diabetic patients, as compared to nondiabetic control patients, thus suggesting exaggerated fetal beta cell function. C-peptide was correlated to both insulin (r = 0.69) and proinsulin (r = 0.35) in the diabetic group only. Infant birth weight and amniotic fluid C-peptide was significantly correlated in both the control group (r = 0.54) and the diabetic group (r = 0.38). Diabetic pregnancies associated with neonatal morbidity (n = 25) had significantly higher mean amniotic fluid concentrations of both insulin and C-peptide than did pregnancies without neonatal morbidity (n = 18). The amniotic fluid values of C-peptide and insulin in these latter two subgroups were overlapping and, therefore, could not serve to predict neonatal outcome in the individual case.

Adult↗
PubMed1982

Amniotic fluid volumes and concentrations of C-peptide in diabetic pregnancies.

Amniotic fluid (AF) volumes were determined by sodium p-aminohippurate (PAH) dilution in a consecutive series of 24 diabetic women at 34-35 weeks gestation. AF and maternal venous blood samples were analysed for C-peptide immunoreactivity (CPR). When the patients were subgrouped according to the presence (n = 17) or absence (n = 8) of neonatal morbidity, AF volumes (1340 +/- 236 ml vs 807 4/- 130 ml; mean +/- SEM), AF concentrations of CPR (1.38 +/- 0.54 nmol/l vs 0.61 +/- 0.14 nmol/l) and maternal blood glucose levels (5.3 +/- 0.2 nmol/l vs 4.8 +/- 0.3 nmol/l) during the last trimester of pregnancy were not different. The total content of CPR was significantly (P less than 0.05) greater in pregnancies with neonatal complications (1.25 +/- 0.31 nmol/ compared with that in pregnancies without neonatal complications (0.54 +/- 0.18 nmol). AF volumes were significantly (P less than 0.02) larger in pregnancies where feeding problems occurred (1546 +/- 307 ml, n = 9) compared with that in pregnancies without such problems (957 +/- 188 ml, n = 16). These findings indicate an impact of fetal hyperinsulinism on the functional maturation of the fetus. When the patients were subgrouped according to the presence or absence of detectable maternal plasma CPR, i.e. greater than 0.05 nmol/l, and to insulin dependent and gestational diabetes no differences of AF volumes, AF concentrations of CPR or total AF contents of CPR were found.

Amniotic Fluid↗
PubMed1982

Amniotic fluid volumes in pregnant diabetics during the last trimester. A comparative study using ultrasound and PAH dilution.

Amniotic fluid was measured by ultrasound and PAH dilution technique in 15 insulin-dependent diabetics during the last trimester of pregnancy. Total uterine volume and fetal volume were estimated by ultrasound. The amniotic fluid volume was obtained by subtracting fetal volume and approximated values for placental volume obtained from the literature from the total uterine volume. The mean amniotic fluid volume determined by ultrasound was 1261 ml (range 278-3563). The mean amniotic fluid volume determined by PAH dilution was 1264 ml (range 344-3852). The values for amniotic fluid determined by these two methods were closely correlated (r = 0.96).

Aminohippuric Acids↗
PubMed1981

Insulin-induced hypoglycaemia in diabetic women during late pregnancy and one year post partum.

Insulin (0.1 IW/kg) later followed by glucose was injected intravenously in nine diabetic women in the supine position both during pregnancy and one year post partum. C-peptide was present in five subjects, indicating some residual beta-cell function. Their mean basal C-peptide level, before insulin, was twice as high in the pregnant as inthe non-pregnant state. C-peptide decreased progressively after insulin. The mean basal plasma glucose level was lower during pregnancy (4.8 mmol/l) than after it (9.6 mmol/l), but decreased to the same level (2.2 mmol/l) after insulin. The rate of fall in glucose was thus lower during pregnancy (kt = 2.54) than after (kt = 4.08), but was unrelated to the basal glucose levels. Basal levels of free fatty acids (FFA), 3-hydroxybutyrate (3-HB), cyclic AMP, and lactate were similar, while glycerol was lower during pregnancy. Insulin-induced changes in FFA, glycerol, 3-HB, cyclic AMP, and lactate were similar during and after pregnancy. Plasma amino acid concentrations were generally lower in pregnancy, significantly so only for arginine and glycine. Amino acid levels were unaffected by insulin in pregnancy, whereas leucine, isoleucine and tyrosine decreased significantly in the non-pregnancy, whereas leucine, isoleucine and tyrosine decreased significantly in the non-pregnancy, whereas leucine, isoleucine and tyrosine decreased significantly in the non-pregnancy state. We conclude that there are differences in metabolic responses to insulin in diabetic women during and after pregnancy, indicating a decreased sensitivity to insulin during pregnancy in some tissues.

3-Hydroxybutyric Acid↗
PubMed1981

Lack of effect on body weight and content of nitrogen and fat after insulin administration to fetal rats.

The effect of fetal insulin injection on body weight and carcass lipid and nitrogen content was studied in four groups of rat fetuses. In each litter, one fetus in each horn was randomly chosen for treatment with either insulin injection, saline injection, insulin solvent injection or sham operation. Injections were given subcutaneously to the fetuses on days 18 1/2, 19 1/2, and 20 1/2 of gestation. The experimental model and the statistical evaluation took into consideration the influence of the fetal position in the uterine horn as well as the variability of fetal size between different litters. Using this experimental model we found that insulin injections to the fetal rat had no effect on body weight and body composition.

Animals↗
PubMed1979

Total cortisol and L/S-ratio in amniotic fluid in late pregnancies complicated by diabetes mellitus.

68 samples of amniotic fluid from 47 women with varying severity of diabetes mellitus and 48 samples from 43 normal women were obtained in the 31st to 40th week of pregnancy before onset of labour. The concentration of total cortisol and the L/S-ratio in amniotic flud were determined and related to gestational age. There was a continous rise of total cortisol with advancing gestational age in the diabetic pregnancies similar to that found in normal pregnancy. Diabetic pregnancies were associated with slightly lower amniotic fluid cortisol levels without significant difference to values found in normal pregnancy. The severity of the disease did not affect the cortisol levels in amniotic fluid. There was no correlation between total cortisol levels and L/S-ratios in amniotic fluid. Determination of total cortisol in amniotic fluid can thus not replace measurements of L/S-ratios to predict fetal lung maturation.

Amniotic Fluid↗
PubMedDate not supplied

Profiles of intermediary metabolites in insulin-dependent pregnant diabetic women with or without endogenous insulin production.

The levels of glucose, free fatty acids (FFA), glycerol, 3-hydroxybutyrate (3-HB), cyclic AMP, and C-peptide immunoreactivity (CPR) were determined in venous plasma samples taken every half hour during an 8-h period under standardized conditions in 10 insulin-dependent pregnant women. The metabolic profiles were determined in each trimester of pregnancy. The women were divided into two groups, one with (group I: 3B, 1C, and 1D according to White's classification) and one without (group II: 1B, 3C, and 1D) measurable plasma CPR levels. Plasma glucose values were significantly higher (P less than 0.01) with greater variability in group II than in group I in the first and second trimesters, while no such difference was found in the third trimester of pregnancy. FFA, glycerol, 3-HB, and cyclic AMP levels were not different between the groups in any trimester of pregnancy. Amniotic fluid CPR was higher and skinfold thickness of the newborn greater in group II than in group I. Neonatal complications occurred only in infants of group II mothers. It is concluded that determination of plasma CPR in diabetic women in early pregnancy could give additional prognostic information to that obtained by the White classification.

Adult↗
PubMedDate not supplied

Effect of treatment with insulin or diet on intermediary metabolites in pregnant women with chemical diabetes in the third trimester of pregnancy.

The diurnal (07(30) - 16(00) profiles of glucose, 3-hydroxybutyrate (3-HB), non-esterified fatty acids (NEFA), and glycerol were studied in 19 pregnant women with gestational diabetes and eight pregnant non-diabetic controls. Nine of the gestational diabetic women were treated with intermediate and in some cases with fast acting insulin and diet and 10 were treated with diet alone. Although fasting plasma glucose levels were normal (less than 6.0 mmol/l) in 8 insulin-treated and 9 diet-treated gestational diabetics before the start of treatment, the profiles of glucose, NEFA and glycerol were generally higher in gestational diabetic compared to non-diabetic pregnant women. The insulin-treated group had lower, but not normal, plasma glucose and higher levels of glycerol than the women treated with diet only. The levels of 3-HB and NEFA were not significantly influenced by the type of therapy. It is suggested that treatment of gestational diabetes should consist of multiple injections of fast acting insulin.

3-Hydroxybutyric Acid↗