Sk. Hunter et al., ENCAPSULATED BETA-ISLET CELLS AS A BIOARTIFICIAL PANCREAS TO TREAT INSULIN-DEPENDENT DIABETES DURING PREGNANCY, American journal of obstetrics and gynecology, 177(4), 1997, pp. 746-752
OBJECTIVE: Our purpose was to determine the effectiveness of the bioar
tificial pancreas technique in correcting (I) maternal carbohydrate me
tabolism and (2) fetal malformation rates in a pregnant diabetic anima
l model. STUDY DESIGN: Insulin secretion from encapsulated rat islets
cultured in the presence of homologous rat prolactin was determined an
d compared with that of controls. Streptozotocin-induced diabetic Balb
/c mice were then transplanted with rat islet cells encapsulated withi
n alginate microbeads and were then bred. Blood glucose determinations
were made after transplantation and throughout gestation. Pups were d
elivered by cesarean section on day 19 of gestation. Outcome parameter
s from the transplanted study animals were compared with those of nond
iabetic controls and untreated diabetic animals. RESULTS: Insulin secr
etion was increased twofold in encapsulated rat islets exposed to pro[
actin compared with control values. Throughout gestation maternal weig
hts and blood glucose levels of transplanted animals were similar to t
hose of nondiabetic controls. A fetal malformation rate of only 1.4% w
as observed in the pups from transplanted animals. CONCLUSIONS: Transp
lanted encapsulated islets are capable of normalizing maternal carbohy
drate metabolism in a pregnant diabetic animal model. This therapy, if
instituted before conception, also appears to eliminate the increase
in fetal malformations seen in diabetic pregnancies.