期刊
INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES
卷 19, 期 11, 页码 -出版社
MDPI
DOI: 10.3390/ijms19113467
关键词
gestational diabetes mellitus; beta-cell; insulin; pregnancy; placenta
资金
- Canadian Institutes for Health Research [136885]
Rates of gestational diabetes mellitus (GDM) are on the rise worldwide, and the number of pregnancies impacted by GDM and resulting complications are also increasing. Pregnancy is a period of unique metabolic plasticity, during which mild insulin resistance is a physiological adaptation to prioritize fetal growth. To compensate for this, the pancreatic beta-cell utilizes a variety of adaptive mechanisms, including increasing mass, number and insulin-secretory capacity to maintain glucose homeostasis. When insufficient insulin production does not overcome insulin resistance, hyperglycemia can occur. Changes in the maternal system that occur in GDM such as lipotoxicity, inflammation and oxidative stress, as well as impairments in adipokine and placental signalling, are associated with impaired beta-cell adaptation. Understanding these pathways, as well as mechanisms of beta-cell dysfunction in pregnancy, can identify novel therapeutic targets beyond diet and lifestyle interventions, insulin and antihyperglycemic agents currently used for treating GDM.
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