Medizinische Universität Graz - Research portal
Selected Publication:
Steiner,K.
Consequences of foetal and neonatal hyperinsulinism on different organ systems
Humanmedizin; [Diplomarbeit] Medical University of Graz;2019. pp. 95
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- Authors Med Uni Graz:
- Advisor:
- Desoye Gernot
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- Abstract:
- BACKGROUND: The increasing incidence of foetal and neonatal hyperinsulinism mainly due to the increase of pregnancies complicated by diabetes mellitus requires a more detailed understanding of the consequences on the foetal and neonatal organism. Macrosomia and excessive accumulation of overall body fat are well known conditions caused by elevated levels of insulin in the offspring. Insulin receptors are found all over the foetal and neonatal organism, therefore additional impact at other body sites is likely. OBJECTIVE: The aim of this thesis is to gain an overview of current available knowledge regarding morphological or functional changes in different organ systems due to hyperinsulinaemia within the foetal and neonatal organism. METHODS: A systematic literature review with literature search within the databases PubMed and Google Scholar was performed. Studies with human data and available in English language were considered for this review. RESULTS: Besides altered body composition, infants with hyperinsulinism showed significant changes in the nervous system and neurodevelopment as well as changes in oxygenation and red blood cell metabolism. Furthermore, muscle tissue, especially cardiac muscle tissues, is susceptible for impaired glucose metabolism. In addition, effects on hepatic morphology and placental appearance are described. Singular studies and case reports are discussing further changes, i.e. in the skin or internal organ systems like kidneys or spleen. CONCLUSION: It seems like almost any tissue can be affected by increased insulin levels, directly or on an indirect way. For the outcome the severity of hyperinsulinaemia is not as significant as the duration and time of onset of elevated insulin levels. Further studies are necessary to investigate the long term consequences of hyperinsulinism lasting into childhood and adulthood. Another aspect of further research is dietary care in pregnancy, which might have an even greater impact than currently thought.