Research priorities in diabetic pregnancy today: the role of animal models

Strict metabolic control has resulted in a striking fall in the rates for stillbirths, neonatal deaths and neonatal morbidity in diabetic pregnancy. However, clinical problems and challenges for research remain, particularly in relation to a high incidence of congenital malformation, low birth weight, and early growth delay; the detection and management of gestational diabetes; insulin delivery systems; the consequences of maternal hypoglycaemia on organogenesis and fetal well-being; the mechanisms underlying various categories of neonatal morbidity, and possible long-term morbidity in the children born to diabetic mothers. The nature of these problems determines that certain fundamental aspects of reproduction which are difficult to study in human pregnancy will have high priority for research. Progress in this field will be heavily dependent on animal models in the foreseeable future.