Diabetes in Pregnancy Researchers

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Terry and Louise Gregg Diabetes in Pregnancy Research Awards

On November 25, 2003 the American Diabetes Association Research Foundation announced the selection of three researchers to receive The Terry and Louise Gregg Diabetes in Pregnancy Research Award. This research award supports investigators who are developing basic science, clinical or translational research focusing on fetal growth and development in pregnant women who have diabetes. The work of these researchers could lead to developments that will result in pregnancies with the best possible outcomes for both mothers and their newborns.

The three award recipients include:

• Patrick M. Catalano, MD
• Ake Lernmark, PhD
• Surendra Sharma, PhD

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Patrick M. Catalano, MD
Case Western Reserve University
Cleveland, Ohio
January 2004 - December 2006

Focus: Role of Leptin in Fetal Growth

Role of placental leptin in the regulation of fetal growth and adiposity

One major complication of diabetic pregnancy is excessive growth of the fetus. Researchers believe that being born too fat creates a greater risk of developing obesity and diabetes later in life. We have previously shown that the placenta controls fetal growth by producing hormones that modify fetal nutrition. A hormone called leptin is produced in the adipose tissue of the mother, the fetus and also in the placenta. When a fetus is obese, particularly in diabetic women, the placenta produces more leptin. The aim of this project is to study how leptin affects the growth of the fetus. We will: 1) study factors that stimulate the production of leptin by the placenta, 2) compare the lipid content in placenta of lean and obese babies of diabetic mothers and 3) determine if the placenta of diabetic women transport more lipids to their babies than non-diabetic women.

These studies will permit us to better define the role of leptin in pregnancy and understand the increased growth of the babies of diabetic mothers, who are at risk for obesity and type 2 diabetes in later life. The long-term goal being to develop therapeutic tools for preventing obesity in utero.

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Ake Lernmark, PhD
University of Washington
Seattle, Washington
January 2004 - December 2006

Focus: The Influence of Maternal Autoantibodies on the Fetus

Maternal autoantibodies as risk factors for diabetes

A child who gets type 1 diabetes before 15 years of age may have been born to a healthy mother who had antibodies against GAD65, IA-2 or insulin. These antibodies predict type 1 diabetes. If a child has cord blood antibodies it usually means that they come from the mother. We will determine if a healthy mother who has GAD65, IA-2 or insulin antibodies during pregnancy not only passed on the antibodies to the child but also an increased risk to get type 1 diabetes later in life. We will determine in samples already collected from mother and cord blood sera from 120 children who later in life developed type 1 diabetes (cord blood serum and a sample from the mother has been stored in a repository). We will also follow (prospective analysis) children who were positive for these antibodies at birth after being born to healthy mothers without or with GAD65, IA-2 or insulin antibodies. Some of these children are already two years of age and they will be followed until the antibodies are come back or the child develops diabetes. The significance is to determine the impact of cord blood autoantibodies on the risk of developing type 1 diabetes.

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Surendra Sharma, PhD
Women & Infants Hospital of Rhode Island
Providence, Rhode Island
January 2004 - December 2006

Focus: The Role of Cytokines in Placental and Fetal Growth

Immune programming of gestational diabetes

Overweight, diabetes, insulin treatment, high glucose levels, and hypertension are phrases that have attracted the general public's attention. Even more worrisome is that when these conditions exist during pregnancy, they may endanger the health of the unborn fetus and mother. There are two types of diabetes. In type 1 diabetes, which is not that common, the body fails to produce insulin and thus insulin must be injected. In pregnancy, patients mostly suffer from type 2 diabetes-associated severe insulin resistance and high glucose levels detected at 24 weeks or later, which can sometimes be controlled by diet and exercise. Although there is a 35-40% recurrence of pregnancy-associated diabetes during a second pregnancy, this condition clears up at birth. Most likely, it happens due to dissociation from the placenta and the agents it was producing to cause severe insulin resistance. The placenta plays several important roles during pregnancy: 1) transporting nutrients and waste products between mother and fetus; 2) producing and providing hormones; 3) maintaining a pregnancy supportive immune environment. It is important to find out whether pregnancy-associated diabetic conditions influence the placenta and the immune responses or vice versa.

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