The ultrasound assessment of adipose tissue deposition in fetuses of 'well controlled' insulin-dependent diabetic pregnancies

Objective: To assess differences in adipose deposition in fetuses from normal pregnancies and women with diabetes. Research design and methods: The study group consisted of 15 well controlled insulin-dependent women with diabetes and 16 controls with a normal glucose. Ultrasound measurements were taken of subcuticular tissue thickness at the abdominal and suprascapular level at 31 and 37 weeks gestation. Triceps and subscapular skinfold thickness were also measured at birth. Results: Gestational age at delivery and birthweights were not significantly different. At 31 weeks, fasting glucose levels were 5.0 ± 1 mmol/l for diabetic vs. 3.3 ± 0.3 mmol/l for controls (P < 0.01), post-prandial 5.6 ± 0.4 vs. 5.1 ± 0.3 mmol/l (P < 0.01). At 37 weeks, they were 4.6 ± 0.2 mmol/l vs. 3.8 ± 1.1 mmol/l (P < 0.01) and 6.0 ± 0.6 mmol/l vs. 5.3 ± 0.3 mmol/l (P < 0.01). Abdominal and suprascapular subcuticular thickness were 4.4 ± 0.1 mm vs. 3.7 ± 0.1 mm (P < 0.05) and 4.3 ± 0.2 mm vs. 3.5 ± 0.2 mm (P < 0.05) at 31; 5.6 ± 0.2 mm vs. 4.8 ± 0.1 mm (P < 0.05) and 5.4 ± 0.2 mm vs. 4.4 ± 0.1 mm (P < 0.05) at 37 weeks. At birth, triceps and suprascapular skinfolds were 4.7 ± 0.1 mm vs. 4.1 ± 0.1 mm (P < 0.05) and 4.7 ± 0.2 mm vs. 3.8 ± 0.1 mm (P < 0.01). Conclusion: Adipose tissue disposition is increased in fetuses of women with well-controlled diabetes. This may be a reflection of higher maternal glucose levels in these women and may explain why even well-controlled diabetic pregnancies are at risk of macrosomia.