Effect of fetal macrosomia on human placental glucose transport and utilization in insulin-treated gestational diabetes

The aim of this study was to compare glucose transport and utilization in human placentae from pregnancies affected by insulin-treated GDM with and without macrosomia, and from non-diabetic control pregnancies. Placental lobules were perfused for 4 h. Maternal D-glucose concentration was 4, 8, 16, or 24 mM while the fetal D-glucose was maintained at 3mM. Hay WW: Regulation of placental metabolism by glucose supply. Reprod Fertil Dev 7 (1995) 365 C-D-glucose and Combs CA,E Gunderson, JL Kitzmiller, LA Gavin, EK Main: Relationship of fetal macrosomia to maternal postprandial glucose control during pregnancy. Diabetes Care 15 (1992) 1251 H-L-glucose were infused into the maternal circulation. Radioactivity, D-glucose and L-lactate levels were measured in the fetal and maternal effluent perfusates. Glucose uptake from the maternal perfusate, and transfer to the fetal effluent were not significantly different between groups. Insulin-treated GDM group without macrosomia had reduced glucose utilization compared to the control group while the insulin-treated GDM group with macrosomia did not. Lactate release into the fetal effluent was significantly reduced in both insulintreated GDM groups compared to the control group. In conclusion, placental glucose utilization is different between insulin-treated GDM placentae with and without fetal macrosomia.