8. Glucose metabolism in pregnancy (workbook) Flashcards
what is altered during pregnancy?
glucose and amino acid metabolism
why is glucose and amino acid metabolism altered during pregnancy?
to favour nutritional supply to the foetus
what is laid down in the first half of pregnancy?
fat
anabolic stage
why is fat laid down in mothers in first half of pregnancy?
helps meet the demands of the foetus later in the pregnancy when the foetus is most demanding metabolically (catabolic)
what are the changes metabolically during pregnancy?
Reduced maternal blood glucose and AA conc.
Diminished maternal responsiveness to insulin in 2nd half of pregnancy (insulin resistance)
Increase in maternal free fatty A, ketone, TAG levels (alternative metabolic fuel)
Increased insulin release in response to a normal meal
what can Diminished maternal responsiveness to insulin in 2nd half of pregnancy (insulin resistance) lead to in some mothers?
gestational diabetes
increased risk of type II diabetes later on in life
how are the metabolic changes during pregnancy achieved?
human placenta lactogen (hPL), oestrogen, progesterone, prolactin
what is hPL also known as?
human chorionic somatomammotrophin, hCS
what does progesterone stimulate?
appetite in first half of pregnancy
aside from stimulating appetite in first half of pregnancy, what is another function of progesterone?
diverts glucose into fat synthesis
what does oestrogen stimulate?
an increase in prolactin release
what generates maternal resistance to insulin?
several hormones:
prolactin, hPL, glucose, cortisol
(possibly oestrogen and progesterone)
by generating maternal resistance to insulin, what is achieved?
maternal glucose usage thus declines
gluconeogenesis increases
maximising availability of glucose to the foetus
how is the mother’s energy needs met in later pregnancy?
by metabolising peripheral fatty acids
