Neonates of diabetic mothers: The starting point for developing novel therapeutic approaches to ischemic heart and brain?

Diabetes mellitus represents the most common medical condition causing complications during pregnancy. However, there is still some controversy surrounding complications. Maternal hyperglycemia leads to fetal hyperglycemia. Offspring of diabetic mothers compensate excess glucose concentrations by producing higher levels of insulin causing transient hyperinsulinemia. Infants of diabetic mothers are at risk for congenital cardiac malformations, of which 40% are with hypertrophic cardiomyopathy. However, regardless of severity, cardiac hypertrophy is transient with echocardiographic resolution within the first months after birth. Neonates of diabetic mothers are more likely to suffer from macrosomia that predisposes the infant to birth asphyxia brain damage. However, there is no evidence for an increase in the incidence of brain injury from perinatal asphyxia in macrosomic babies of diabetic mothers in comparison to macrosomic newborns of non-diabetic mothers. We hypothesize that infants of diabetic mother may represent the starting point for developing novel approaches to the treatment and prevention of obstructive hypertrophic cardiomyopathy, AMI and stroke at every age.