physiological effects of pregnancy on glucose metabolism
Last reviewed 05/2023
Pregnancy is a diabetogenic state for the following reasons:
- human placental lactogen has anti-insulin and lipolytic effects. It increases the glucose levels in maternal plasma and thus makes more glucose available to the fetus
- steroid hormones have an anti-insulin effect (especially corticosteroids and progesterone)
- some insulin may be destroyed by the placenta
Despite the insulin resistance of pregnancy, hyper- insulinaemia results in fasting levels of blood glucose which are 0.5 mM lower than in non-pregnant women.
Insulin resistance is made evident by the higher peaks of blood glucose following meals.
The diabetogenic effects of pregnancy are increased by:
- maternal obesity
- repeated pregnancy
Glycosuria is more common during pregnancy due to a lowered renal threshold for glucose excretion.