Mayer called "embryopathia diabetica" as the abnormalities of fetuses of diabetic mothers. These abnormalities including congenital malformations (CM) are seen under inadequate control of maternal diabetes. CM and respiratory distress syndrome are still main causes of death among IDM. I analysed the frequency, type of malformation, and relationship of maternal diabetes treatment with regards to 117 babies born to 93 cases of pregnant diabetics treated by us. CM in the IDM in Japan over a ten year period during 1971-1980 was also surveyed by questionnaire. To elusidate the mechanism of CM, the influence of maternal hyperglycemia and hypoglycemia on the fetuses was observed using streptozotocine induced diabetic rats and insulin induced hypoglycemic rats. The frequency of CM was 16.2%, 19 out of 117 newborns in our hospital compared with 1.5% of controls. Although most of the IDM had minor anomalies, four newborns died due to major anomalies. The 78% of mothers who had infants with CM showed poor control in the first trimester. Specially, fasting blood glucose of pregnant diabetics who had neonates with major anomaly was over 200 mg/dl in the early stages of their gestation in all cases. In a survey in Japan. CM was 6.2%, 44 out of 1042 IDM. The types of CM seen in IDM are distributed through all organ systems. Including the results of animal experiments, it is suggested that CM is not related to maternal hypoglycemia but hyperglycemia in very early stages of gestation.
