The Pathophysiology of Gestational Diabetes Mellitus
Abstract
:1. Introduction
1.1. Glucose Regulation during Healthy Pregnancy
1.2. Classification and Prevalence of Gestational Diabetes
1.3. Forms of Gestational Diabetes
1.4. Risk Factors for Gestational Diabetes
1.5. Consequences of Gestational Diabetes
2. Pathophysiology of Gestational Diabetes
2.1. β-Cell Dysfunction
2.2. Chronic Insulin Resistance
2.3. Neurohormonal Networks
2.3.1. Leptin
2.3.2. Adiponectin
2.4. Adipose Tissue
2.4.1. Energy Storage
2.4.2. Adipose Tissue Inflammation
2.5. Liver
2.6. Skeletal and Cardiac Muscle
2.7. Gut Microbiome
2.8. Oxidative Stress
2.9. Placental Transport
3. Opportunities and Considerations for Future Study
4. Conclusions
Author Contributions
Funding
Conflicts of Interest
References
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Criteria | Pregnancies | Timing of OGTT | Steps | Glucose Load (g) | Glucose Threshold (mmol/L) | |||
---|---|---|---|---|---|---|---|---|
Fasting | 1 h | 2 h | 3 h | |||||
O’Sullivan, 1964 | All | 24–28 weeks | 2 | 100 | 5.0 | 9.2 | 8.1 | 6.9 |
WHO, 1999 | All | 24–28 weeks | 1 | 75 | 7.0 | — | 7.8 | — |
American Diabetes Association (ADA), 2004 | High and medium risk | 14–18 weeks for high risk, 28–32 weeks for medium risk | 2 | 100 | 5.3 | 10.0 | 8.6 | 7.8 |
National Institute for Health and Care Excellence (NICE), 2015 | High risk | As early as possible | 1 | 75 | 5.6 | — | 7.8 | — |
IADPSG, 2010 | All | 24–28 weeks | 1 | 75 | 5.1 | 10.0 | 8.5 | — |
WHO, 2013 | ||||||||
ADA, 2016 |
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Plows, J.F.; Stanley, J.L.; Baker, P.N.; Reynolds, C.M.; Vickers, M.H. The Pathophysiology of Gestational Diabetes Mellitus. Int. J. Mol. Sci. 2018, 19, 3342. https://doi.org/10.3390/ijms19113342
Plows JF, Stanley JL, Baker PN, Reynolds CM, Vickers MH. The Pathophysiology of Gestational Diabetes Mellitus. International Journal of Molecular Sciences. 2018; 19(11):3342. https://doi.org/10.3390/ijms19113342
Chicago/Turabian StylePlows, Jasmine F, Joanna L Stanley, Philip N Baker, Clare M Reynolds, and Mark H Vickers. 2018. "The Pathophysiology of Gestational Diabetes Mellitus" International Journal of Molecular Sciences 19, no. 11: 3342. https://doi.org/10.3390/ijms19113342