Gestational Diabetes Flashcards
Gestational diabetes
-normal changes in insulin sensitivity and metabolism
-hyperglycemia during pregnancy
-24-28 wekek OGTT
-2-10% of pregnancies
Insulin response in early pregnancy
-increased
-hypoglycemia in T1D
-growth of placenta, inc maternal fat storage
Insulin response in late preganncy
-decreased
-growth of fetus
-compensated by increased insulin secretion
Gestational diabetes onset
-around week 24
-rapid growth stage after fetus formed
-not associated w defects in fetal development
Macrosomia (Fat Baby)
-fetus has access to excessive glucose
=produce high levels of insulin and stores excess as fat
Complications of gestational diabetes
-damage to baby during birth (shoulders)
-neonatal hypoglycemia
-breathing probs (high glucose delays maturation of lung) (most common before 37 weeks)
Gestational diabetes and risk of Type 2
-mother has 30-50% T2D risk
-child inc risk (fetal programming)
Maternal insulin resistance
-target tissues cant respond to insulin
-insulin doesnt cross placenta (glucose does)
-factors secreted by placenta into maternal circulation
Placental hormones associated w gestational insulin resistance
-CRH- Cortisol
-Progesterone
-Placental GH
-Placental Lactogens
CRH-Cortisol
-placental hormone
-inc as preg progresses
-oppose insulin action (glucocortcoids)
Progesterone
-inc as preg progresses
Placental GH (GH-V)
-released during last half of gestation
-may contribute to insulin resistance
Placental Lactogens
-inc as preg progresses
-85% similar to GH
-contributes to insulin resistance
Placental lactogen in mother
-glucose intolerance
-lipolysis
-proteolysis
-slide 128
Hormones that increase B-cell mass in pregnancy
-Prolactin (mutations in receptor associated w GDM)
-Placental lactogen (activates PRL and GH receptors
