Pregnancy is diabetogenic, among others, the following factors: (4)
Insulin resistance: the most important factor is the gradual increase in insulin resistance that occurs during pregnancy. This insulin resistance is the result of the hyperglycemic effect of counter-regulatory hormones secreted by the placenta and is overcome by increased insulin secretion, resulting in a concomitant hyperinsulinemia. Similarly, there is increased destruction of insulin by the kidney and placental insulinasas.
Increased lipolysis: Mother uses fat to meet their needs and keep glucose to cover the fetus.
Changes in gluconeogenesis: the fetus uses alanine and other amino acids, depriving the mother of the main substrates for gluconeogenesis. Now, this consumption of glucose and amino acids by the fetus explains the tendency to fasting hypoglycemia during pregnancy (1).
Summarizing, the metabolism of C H during pregnancy is characterized by:
Tendency to hypoglycemia and ketosis in fasting
postprandial hyperglycemia tendency
Hyperinsulinemia and insulin resistance