Peri-implantation embryopathy induced by maternal diabetes

Almost 10 years ago, it was proposed that the packaging of all devices and supplies used by diabetic patients for routine care should carry this warni ng label:'Poor control of diabetes may cause birth defects. See your physic ian before becoming pregnant'. The present article reviews the evidence sup porting the hypothesis that in mouse and rat experimental models, maternal pre-conceptional diabetes induces severe developmental alterations in embry os before and at implantation The review (i) summarizes observations on emb ryos exposed to maternal diabetes in utero, (ii) summarizes data obtained b y culturing embryos in vitro in the presence of high concentrations of D-gl ucose, (iii) discusses the possibility that alterations in the release of c ytokines and growth factors by uterine cells contribute to early embryopath y and (iv) summarizes the evidence that apoptosis, a process of normal embr yonic development, may be disrupted in blastocysts exposed to diabetic cond itions in vivo and in vitro.