GESTATIONAL DIABETES MELLITUS: HORMONAL CHANGES AND MECHANISMS OF INSULIN RESISTANCE

Аннотация

Physiologically, pregnancy induces a state of progressive insulin resistance to ensure adequate glucose supply for the growing fetus. While this adaptation is beneficial in normal pregnancies, in predisposed women it leads to hyperglycemia, β-cell dysfunction, and the clinical manifestation of GDM. Elevated levels of placental hormones — including human placental lactogen (hPL), cortisol, estrogen, progesterone, and placental growth hormone — antagonize insulin action, decrease maternal insulin sensitivity, and alter lipid and carbohydrate metabolism.