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KEY FACTS
Terminology
Imaging
Pathology
Clinical Issues
TERMINOLOGY
Definitions
Pregestational diabetes (type I or II): Diabetes mellitus diagnosis predates pregnancy
Gestational diabetes mellitus (GDM): Any degree of glucose intolerance initially diagnosed during pregnancy
Diagnosis by oral glucose tolerance test from 24-28 weeks gestation
GDM, by definition, resolves following pregnancy, although recurrence in subsequent pregnancies is common
Increased risk of developing type II diabetes (40-50% within 10 years)
Controversy exists regarding risk of anomalies in GDM
Anomalies in GDM may reflect undiagnosed type II diabetic
IMAGING
General Features
Ultrasonographic Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Staging, Grading, & Classification
Microscopic Features
CLINICAL ISSUES
Presentation
Natural History & Prognosis
Treatment
Selected References
Bohuslavova R et al: Gene expression profiling of changes induced by maternal diabetes in the embryonic heart. Reprod Toxicol. 57:147-56, 2015
Dong D et al: New development of the yolk sac theory in diabetic embryopathy: molecular mechanism and link to structural birth defects. Am J Obstet Gynecol. 214(2): 192-202, 2015
Dong D et al: Maternal diabetes triggers DNA damage and DNA damage response in neurulation stage embryos through oxidative stress. Biochem Biophys Res Commun. 467(2):407-12, 2015
Gabbay-Benziv R et al: Birth defects in pregestational diabetes: Defect range, glycemic threshold and pathogenesis. World J Diabetes. 6(3):481-8, 2015
López-Escobar B et al: The effect of maternal diabetes on the Wnt-PCP pathway during embryogenesis as reflected in the developing mouse eye. Dis Model Mech. 8(2):157-68, 2015
Mitanchez D et al: The offspring of the diabetic mother--short- and long-term implications. Best Pract Res Clin Obstet Gynaecol. 29(2):256-69, 2015
Ornoy A et al: Effect of maternal diabetes on the embryo, fetus, and children: congenital anomalies, genetic and epigenetic changes and developmental outcomes. Birth Defects Res C Embryo Today. 105(1):53-72, 2015
Wang F et al: Advances in revealing the molecular targets downstream of oxidative stress-induced proapoptotic kinase signaling in diabetic embryopathy. Am J Obstet Gynecol. 213(2):125-34, 2015
Wang F et al: Oxidative stress is responsible for maternal diabetes-impaired transforming growth factor beta signaling in the developing mouse heart. Am J Obstet Gynecol. 212(5):650.e1-11, 2015
Wang F et al: Dominant negative FADD dissipates the proapoptotic signalosome of the unfolded protein response in diabetic embryopathy. Am J Physiol Endocrinol Metab. 309(10):E861-73, 2015
Yang P et al: Decoding the oxidative stress hypothesis in diabetic embryopathy through proapoptotic kinase signaling. Am J Obstet Gynecol. 212(5):569-79, 2015
Zhong J et al: Punicalagin exerts protective effect against high glucose-induced cellular stress and neural tube defects. Biochem Biophys Res Commun. 467(2):179-84, 2015
El Hajj N et al: Epigenetics and life-long consequences of an adverse nutritional and diabetic intrauterine environment. Reproduction. 148(6):R111-20, 2014
Moreli JB et al: DNA damage and its cellular response in mother and fetus exposed to hyperglycemic environment. Biomed Res Int. 2014:676758, 2014
Persson M et al: Perinatal outcome in relation to fetal sex in offspring to mothers with pre-gestational and gestational diabetes--a population-based study. Diabet Med. 31(9):1047-54, 2014
Wei D et al: Increased DNA methyltransferase 3b (Dnmt3b)-mediated CpG island methylation stimulated by oxidative stress inhibits expression of a gene required for neural tube and neural crest development in diabetic pregnancy. Diabetes. 63(10):3512-22, 2014
Zhao Z: TGFβ and Wnt in cardiac outflow tract defects in offspring of diabetic pregnancies. Birth Defects Res B Dev Reprod Toxicol. 101(5):364-70, 2014
Castori M: Diabetic embryopathy: a developmental perspective from fertilization to adulthood. Mol Syndromol. 4(1-2):74-86, 2013
Heerwagen MJ et al: Maternal obesity and fetal metabolic programming: a fertile epigenetic soil. Am J Physiol Regul Integr Comp Physiol. 299(3):R711-22, 2010
Lisowski LA et al: Congenital heart disease in pregnancies complicated by maternal diabetes mellitus. An international clinical collaboration, literature review, and meta-analysis. Herz. 35(1):19-26, 2010
Adam MP et al: Preaxial hallucal polydactyly as a marker for diabetic embryopathy. Birth Defects Res A Clin Mol Teratol. 85(1):13-9, 2009
Sugimura Y et al: Prevention of neural tube defects by loss of function of inducible nitric oxide synthase in fetuses of a mouse model of streptozotocin-induced diabetes. Diabetologia. 52(5):962-71, 2009
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References
Tables
Tables
KEY FACTS
Terminology
Imaging
Pathology
Clinical Issues
TERMINOLOGY
Definitions
Pregestational diabetes (type I or II): Diabetes mellitus diagnosis predates pregnancy
Gestational diabetes mellitus (GDM): Any degree of glucose intolerance initially diagnosed during pregnancy
Diagnosis by oral glucose tolerance test from 24-28 weeks gestation
GDM, by definition, resolves following pregnancy, although recurrence in subsequent pregnancies is common
Increased risk of developing type II diabetes (40-50% within 10 years)
Controversy exists regarding risk of anomalies in GDM
Anomalies in GDM may reflect undiagnosed type II diabetic
IMAGING
General Features
Ultrasonographic Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Staging, Grading, & Classification
Microscopic Features
CLINICAL ISSUES
Presentation
Natural History & Prognosis
Treatment
Selected References
Bohuslavova R et al: Gene expression profiling of changes induced by maternal diabetes in the embryonic heart. Reprod Toxicol. 57:147-56, 2015
Dong D et al: New development of the yolk sac theory in diabetic embryopathy: molecular mechanism and link to structural birth defects. Am J Obstet Gynecol. 214(2): 192-202, 2015
Dong D et al: Maternal diabetes triggers DNA damage and DNA damage response in neurulation stage embryos through oxidative stress. Biochem Biophys Res Commun. 467(2):407-12, 2015
Gabbay-Benziv R et al: Birth defects in pregestational diabetes: Defect range, glycemic threshold and pathogenesis. World J Diabetes. 6(3):481-8, 2015
López-Escobar B et al: The effect of maternal diabetes on the Wnt-PCP pathway during embryogenesis as reflected in the developing mouse eye. Dis Model Mech. 8(2):157-68, 2015
Mitanchez D et al: The offspring of the diabetic mother--short- and long-term implications. Best Pract Res Clin Obstet Gynaecol. 29(2):256-69, 2015
Ornoy A et al: Effect of maternal diabetes on the embryo, fetus, and children: congenital anomalies, genetic and epigenetic changes and developmental outcomes. Birth Defects Res C Embryo Today. 105(1):53-72, 2015
Wang F et al: Advances in revealing the molecular targets downstream of oxidative stress-induced proapoptotic kinase signaling in diabetic embryopathy. Am J Obstet Gynecol. 213(2):125-34, 2015
Wang F et al: Oxidative stress is responsible for maternal diabetes-impaired transforming growth factor beta signaling in the developing mouse heart. Am J Obstet Gynecol. 212(5):650.e1-11, 2015
Wang F et al: Dominant negative FADD dissipates the proapoptotic signalosome of the unfolded protein response in diabetic embryopathy. Am J Physiol Endocrinol Metab. 309(10):E861-73, 2015
Yang P et al: Decoding the oxidative stress hypothesis in diabetic embryopathy through proapoptotic kinase signaling. Am J Obstet Gynecol. 212(5):569-79, 2015
Zhong J et al: Punicalagin exerts protective effect against high glucose-induced cellular stress and neural tube defects. Biochem Biophys Res Commun. 467(2):179-84, 2015
El Hajj N et al: Epigenetics and life-long consequences of an adverse nutritional and diabetic intrauterine environment. Reproduction. 148(6):R111-20, 2014
Moreli JB et al: DNA damage and its cellular response in mother and fetus exposed to hyperglycemic environment. Biomed Res Int. 2014:676758, 2014
Persson M et al: Perinatal outcome in relation to fetal sex in offspring to mothers with pre-gestational and gestational diabetes--a population-based study. Diabet Med. 31(9):1047-54, 2014
Wei D et al: Increased DNA methyltransferase 3b (Dnmt3b)-mediated CpG island methylation stimulated by oxidative stress inhibits expression of a gene required for neural tube and neural crest development in diabetic pregnancy. Diabetes. 63(10):3512-22, 2014
Zhao Z: TGFβ and Wnt in cardiac outflow tract defects in offspring of diabetic pregnancies. Birth Defects Res B Dev Reprod Toxicol. 101(5):364-70, 2014
Castori M: Diabetic embryopathy: a developmental perspective from fertilization to adulthood. Mol Syndromol. 4(1-2):74-86, 2013
Heerwagen MJ et al: Maternal obesity and fetal metabolic programming: a fertile epigenetic soil. Am J Physiol Regul Integr Comp Physiol. 299(3):R711-22, 2010
Lisowski LA et al: Congenital heart disease in pregnancies complicated by maternal diabetes mellitus. An international clinical collaboration, literature review, and meta-analysis. Herz. 35(1):19-26, 2010
Adam MP et al: Preaxial hallucal polydactyly as a marker for diabetic embryopathy. Birth Defects Res A Clin Mol Teratol. 85(1):13-9, 2009
Sugimura Y et al: Prevention of neural tube defects by loss of function of inducible nitric oxide synthase in fetuses of a mouse model of streptozotocin-induced diabetes. Diabetologia. 52(5):962-71, 2009
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