Monocyte adhesion to decidual endothelial cells is increased in pregnancies complicated by type 1 diabetes but not by gestational diabetes.

T ype 1 diabetes complicates 1 of every 200 pregnancies and gestational diabetes a further 2–3% of pregnancies (1). Systemic atheromatous vascular disease can develop or accelerate during diabetic pregnancy. We and others (2) have observed similar vascular lesions in placental bed vessels (Fig. 1A) associated with impaired placental function and fetal growth. Genesis of atheroma involves adherence of peripheral blood monocytes to endothelium (3–5). To determine whether a similar process underlies the placental bed vasculopathy of diabetes, we examined cell adhesion in an in vitro coculture system using decidual endothelial cells from normal pregnancies and monocytes from both normal and diabetic pregnancies.