Insulin and Lung Development

Abstract

Infants of diabetic mothers have an elevated incidence of respiratory distress syndrome of the newborn (RDS), a disease which is caused by pulmonary surfactant deficiency associated with inadequate numbers of differentiated alveolar type II cells in the lung (1,2). Pulmonary surfactant, which functions to reduce surface tension at the air-alveolar interface, is made up of glycerophospholipids (approx 80% by weight), cholesterol (approx 10%) and the surfactant-associated proteins (approx 10%) (3). The fetus of the diabetic mother tends to have high serum glucose and insulin levels as a result of maternal hyperglycemia (4). Robert et al. (1) first advanced the hypothesis that high levels of insulin might delay lung development in the fetus of the gestational diabetic woman. In this chapter, we will review the literature concerning the effects f maternal diabetes, glucose, and, in particular, insulin on fetal lung development.