Glucose, foetal growth, and pregnancy

Normal pregnancy is marked by significant changes in maternal insulin resistance and hyperinsulinaemia from progressively increasing insulin secretion during gestation. The regulation of glucose metabolism during pregnancy is complex. After a successful implantation of a genetically normal foetus, the placenta plays a critical role in the delivery of nutrients and in the tissue-specific regulation of normal foetal growth. In addition to its metabolic and endocrine function, the placenta secretes cytokines that significantly impact foetal growth. Pregnancies complicated by gestational diabetes mellitus (GDM) have an increased risk of foetal overgrowth (macrosomia or large for gestational age birth), higher perinatal morbidity and mortality, and presage a long-term risk of developing type 2 diabetes for the mother.