Abstract
The Center for Disease Control and Prevention ranks diabetes mellitus (DM) as the seventh leading cause of death in the USA. The most prevalent forms of DM include Type 2 DM, Type 1 DM, and gestational diabetes mellitus (GDM). While the acute problem of diabetic hyperglycemia can be clinically managed through dietary control and lifestyle changes or pharmacological intervention with oral medications or insulin, long-term complications of the disease are associated with significant morbidity and mortality. These long-term complications involve nearly all organ systems of the body and share common pathologies associated with endothelial cell abnormalities. To better understand the molecular mechanisms underlying DM as related to future long-term complications following hyperglycemia, we have undertaken a study to determine the frequency that GDM did or did not occur in the second pregnancy of women who experienced GDM in their first pregnancy between 2013 and 2018 at Mayo Clinic, Rochester, MN. Within the five-year period of the study, the results indicate that 7,330 women received obstetrical care for pregnancy during the study period. Of these, 150 developed GDM in their first pregnancy and of these, 42 (28%) had a second pregnancy. Of these 42 women, 20 again developed GDM and 22 did not develop GDM in their second pregnancy within the study period. Following the occurrence of GDM in the first pregnancy, the study (1) established the number of women with and without GDM in the second pregnancy and (2) confirmed the feasibility to study diabetic metabolic memory using maternal placental tissue from GDM women. These studies represent Phase I of a larger research project whose goal is to analyze epigenetic mechanisms underlying true diabetic metabolic memory using endothelial cells isolated from the maternal placenta of women with and without GDM as described in this article.
Highlights
The Center for Disease Control and Prevention ranks diabetes mellitus (DM) as the seventh leading cause of death in the USA with some 80,000 fatalities a year [1]
The disease has a number of prevalent forms such as Type 1 DM (T1DM), Type 2 DM (T2DM), and gestational diabetes mellitus (GDM), as well as a number of minor forms that involve induced hyperglycemia [5]
While the acute problem of hyperglycemia can be clinically managed through dietary control and lifestyle changes or pharmacological intervention with oral hypoglycemic medications or insulin [4], the more severe aspects of the disease include mortality resulting from long-term complications [4] such as cardiovascular disease involving both microvascular and macrovascular components [10,11,12,13], retinopathy, nephropathy, neuropathy, and impaired wound healing [14,15,16]
Summary
The Center for Disease Control and Prevention ranks diabetes mellitus (DM) as the seventh leading cause of death in the USA with some 80,000 fatalities a year [1]. While the acute problem of hyperglycemia can be clinically managed through dietary control and lifestyle changes or pharmacological intervention with oral hypoglycemic medications or insulin [4], the more severe aspects of the disease include mortality resulting from long-term complications [4] such as cardiovascular disease involving both microvascular and macrovascular components [10,11,12,13], retinopathy, nephropathy, neuropathy, and impaired wound healing [14,15,16] These long-term complications involve most organ systems of the body and share common pathologies associated with endothelial cell abnormalities. Endothelial cell dysfunction in DM [17] takes on different forms to include (1) altered compliance [18], (2) acquired vascular flow abnormalities [19], and (3) altered blood vessel growth through both angiogenesis [10, 12, 20] and neovascularization [13, 21,22,23,24]
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