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Placental development and function are tightly regulated by endocrine, paracrine, and autocrine factors present in the maternal and the fetal circulation and in the placenta. Gestational diabetes (GDM) is associated with a derangement of the concentration of several hormones, cytokines, metabolites, and growth factors in both circulations that may subsequently alter placental morphology and function...
This plasticity of β-cell function in the face of progressive insulin resistance is the hallmark of normal glucose regulation during pregnancy. Like other forms of hyperglycemia, GDM is characterized by an insulin supply that is insufficient to meet the body’s insulin needs. The causes of an insufficient insulin supply reflect the causes of hyperglycemia in general, including autoimmune disease, monogenic...
Obesity and pregnancy are associated with a combination of insulin resistance and inflammatory changes that exacerbate, in combination, potentially increasing risk for GDM and subsequent progression to Type 2 diabetes. During mid-pregnancy, skeletal muscle and adipose tissue progressively shift from glucose to fat metabolism, due to insulin resistance associated with placental hormones, primarily...
Chronic subclinical inflammation and dysregulation of adipocyte-derived proteins (adipokines) have emerged as novel, non-traditional risk factors for both type 2 diabetes and cardiovascular disease. Since GDM is associated with future risk of both of these conditions, study of these novel risk factors in women with GDM has grown. Indeed, these factors may potentially contribute to (i) the development...
Dyslipidemia in gestational diabetes (GDM) consists of an ∼50 mg/dL increase in triglyceride, an ∼4 mg/dL decrease in high density lipoprotein (HDL), and generally lower low density lipoprotein (LDL) levels by ∼30mg/dL, more small dense LDL, and greater susceptibility of LDL to oxidation. Predictors of increased birth weight are the postprandial hyperglycemia of GDM and elevated triglyceride. Predictors...
Hypertensive disorders of pregnancy are common medical complications and are also associated with insulin resistance during pregnancy. While physiologic mechanisms are not completely elucidated, hypertension and gestational diabetes (GDM) have overlapping etiologies and adverse effects on outcomes. Several treatment strategies aimed at normotension may be effective for reduction in perinatal morbidity,...
Identifying genes underlying complex diseases hold the promise of new drug targets, improved interventions, and the advent of so-called “personalized medicine.” For almost 2 decades, investigators have attempted to identify genes underlying gestational diabetes mellitus (GDM) and type 2 diabetes mellitus (T2DM), but until recently were mostly unsuccessful. Improvements in genetic information and technology...
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