DIABETIC EMBRYOPATHY - POSSIBLE PATHOGENESIS

Despite recent emphasis upon improved metabolic control during early d iabetic pregnancy, the offspring of insulin-dependent diabetic women c ontinue to have a 2- to 4-fold increased risk of congenital malformati ons. We recently evaluated the affected offspring of 4 insulin-depende nt diabetic women. All had abnormal ears in association with vertebral defects. Our analysis of the structural defects of these infants and a review of the literature suggest that the pathogenesis of some cases of the diabetic embryopathy may involve a primary insult to developin g somite mesoderm and associated cephalic neural crest cells. (C) 1995 Wiley-Liss, Inc.