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Pathogenesis of Gestational Diabetes Mellitus

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Abstract

According to the American Diabetes Association (ADA), gestational diabetes mellitus (GDM) is defined as hyperglycemia diagnosed in the second or third trimester of pregnancy that was not overt diabetes before gestation. It constitutes the most common metabolic disease of pregnancy, with a continuously increasing prevalence (Ferrara, Diabetes Care 2007;30:141–146; Negrato, Diabetol Metab Syndr 2013;5:22). It has been associated with several maternal and fetal/neonatal complications (Mitanchez, Diabetes Metab 2010;36:617–627; Lowe et al. Diabetes Care 2012;35:574–580). Increased maternal age; increased pre-pregnancy body mass index (BMI); excessive weight gain during pregnancy; Aboriginal Australia, Middle East and pacific island ethnicity; positive family history of GDM; and higher parity are established risk factors for develo** GDM (Di Cianni et al. Diabetes Res Clin Pract 2003;62:131–137; Yuen and Wong, World J Diabetes 2015;6:1024–1032). GDM, similarly to type 2 diabetes mellitus (T2DM), is a multifactorial disease; its pathogenetic mechanisms are not yet fully understood. Genetic predisposition and acquired factors (lifestyle and environmental) that affect insulin sensitivity and β-cell function have been implicated in GDM development and determine the disease severity (Baz et al., Eur J Endocrinol 2016;174:43–51). Hormonal, inflammatory, and immunologic factors contribute to insulin production, secretion, and action, resulting in uncompensated insulin resistance and GDM development. Suboptimal lifestyles, such as hypercaloric diet, unhealthy nutritional habits, and reduced physical activity, contribute to central obesity and acquired triggering factors for GDM (Oken et al. Obstet Gynecol 2006;108:1200–1207; Zhang and Ning, Am J Clin Nutr 2011;94:1975S–1979).

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  1. Unit of Reproductive Endocrinology, First Department of Obstetrics and Gynecology, Papageorgiou General Hospital, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece

    Evangelia Kintiraki, Gesthimani Mintziori & Dimitrios G. Goulis

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    Joel Rodriguez-Saldana

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Kintiraki, E., Mintziori, G., Goulis, D.G. (2023). Pathogenesis of Gestational Diabetes Mellitus. In: Rodriguez-Saldana, J. (eds) The Diabetes Textbook. Springer, Cham. https://doi.org/10.1007/978-3-031-25519-9_15

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