Determinants of Maternal Insulin Resistance during Pregnancy: An Updated Overview

J Diabetes Res. 2019 Nov 19:2019:5320156. doi: 10.1155/2019/5320156. eCollection 2019.

Abstract

Insulin resistance changes over time during pregnancy, and in the last half of the pregnancy, insulin resistance increases considerably and can become severe, especially in women with gestational diabetes and type 2 diabetes. Numerous factors such as placental hormones, obesity, inactivity, an unhealthy diet, and genetic and epigenetic contributions influence insulin resistance in pregnancy, but the causal mechanisms are complex and still not completely elucidated. In this review, we strive to give an overview of the many components that have been ascribed to contribute to the insulin resistance in pregnancy. Knowledge about the causes and consequences of insulin resistance is of extreme importance in order to establish the best possible treatment during pregnancy as severe insulin resistance can result in metabolic dysfunction in both mother and offspring on a short as well as long-term basis.

Publication types

  • Review

MeSH terms

  • Adipokines / metabolism
  • Chorionic Gonadotropin / metabolism
  • Cytokines / metabolism
  • Diabetes, Gestational / epidemiology*
  • Diabetes, Gestational / genetics
  • Diabetes, Gestational / metabolism
  • Diet*
  • Epigenesis, Genetic
  • Estradiol / metabolism
  • Exosomes / metabolism
  • Female
  • Gastrointestinal Microbiome
  • Genetic Predisposition to Disease
  • Gestational Age
  • Growth Hormone / metabolism
  • Humans
  • Hydrocortisone / metabolism
  • Insulin Resistance*
  • Obesity, Maternal / epidemiology*
  • Obesity, Maternal / metabolism
  • Placenta / metabolism
  • Placental Hormones / metabolism
  • Placental Lactogen / metabolism
  • Polycystic Ovary Syndrome / epidemiology
  • Polycystic Ovary Syndrome / metabolism
  • Pregnancy
  • Progesterone / metabolism
  • Prolactin / metabolism
  • Sedentary Behavior*

Substances

  • Adipokines
  • Chorionic Gonadotropin
  • Cytokines
  • GH2 protein, human
  • Placental Hormones
  • Progesterone
  • Estradiol
  • Prolactin
  • Growth Hormone
  • Placental Lactogen
  • Hydrocortisone