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| SPECIALIST ANSWERS
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Question |
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What is pathogenesis for polycythemia in infants of diabetic mothers?
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Answer |
In infants of diabetis mothers the fetus is subjected to high levels of glucose during times of maternal hyperglycemia. After 20 weeks' gestation, the fetus responds to hyperglycemia with pancreatic beta-cell hyperplasia and increased insulin levels. Chronic fetal hyperglycemia and hyperinsulinemia increase the fetal basal metabolic rate and oxygen consumption, leading to a relative hypoxic state. The fetus responds by increasing oxygen-carrying capacity through increased erythropoieten production, possibly leading to polycythemia.
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