Intermediate metabolism in normal pregnancy and in gestational diabetes

Di Cianni, G.; Miccoli, R.; Volpe, L.; Lencioni, C.; Del Prato, S.

doi:10.1002/dmrr.390

Cited by 406Gestational Diabetes Research and ManagementPancreatic function and diabetesBirth, Development, and Health

Intermediate metabolism in normal pregnancy and in gestational diabetes

Di Cianni, G., Miccoli, R., Volpe, L., Lencioni, C., Del Prato, S.·2003·Diabetes/Metabolism Research and Reviews

DOI 10.1002/dmrr.390

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Abstract

Complex though integrated hormonal and metabolic changes characterize pregnancy. In the face of progressive decline in insulin action, glucose homeostasis is maintained through a compensatory increase in insulin secretion. This switches energy production from carbohydrates to lipids, making glucose readily available to the fetus. This precise and entangled hormonal and metabolic condition can, however, be disrupted and diabetic hyperglycemia can develop (gestational diabetes). The increase in plasma glucose level is believed to confer significant risk of complications to both the mother and the fetus and the newborn. Moreover, exposition of fetal tissues to the diabetic maternal environment can translate into an increased risk for development of diabetes and/or the metabolic syndrome in the adult life. In women with previous gestational diabetes, the risk of developing type 2 diabetes is greatly enhanced, to the point that GDM represents an early stage in the natural history of type 2 diabetes. In these women, accurate follow-up and prevention strategies are needed to reduce the subsequent development of overt diabetes. This paper will review current knowledge on the modifications occurring in normal pregnancy, while outlining the mechanisms. In this paper, we will review the changes of intermediary metabolism occurring during pregnancy. In particular, we will outline the mechanisms responsible for gestational diabetes; the link between these alterations and associated maternal and neonatal morbidity will be examined.

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During early gestation, insulin sensitivity increases, promoting the uptake of glucose into adipose stores.
“During early gestation, insulin sensitivity increases, promoting the uptake of glucose into adipose stores in preparation for the energy demands of later pregnancy [5].”
From The Pathophysiology of Gestational Diabetes Mellitus (2018) · cites this paper as [5]

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Background
Effects of Prolactin and Glycosylated Prolactin on (Pro)insulin Synthesis and Insulin Release from Cultured Rat Pancreatic Islets
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Impaired insulin receptor binding and postbinding defects of adipocytes from normal and diabetic pregnant women
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Host Remodeling of the Gut Microbiome and Metabolic Changes during Pregnancy
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The Pathophysiology of Gestational Diabetes Mellitus
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“During early gestation, insulin sensitivity increases, promoting the uptake of glucose into adipose stores in preparation for the energy demands of later pregnancy [5].”
Background
Gestational diabetes mellitus: an updated overview
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A Genome-Wide Association Study of Gestational Diabetes Mellitus in Korean Women
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Maternal Omega-3 Nutrition, Placental Transfer and Fetal Brain Development in Gestational Diabetes and Preeclampsia
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Epigenetic signatures of gestational diabetes mellitus on cord blood methylation
Haertle, L., Hajj, N. E., Dittrich, M. T., Müller, T., Nanda, I., Lehnen, H., & Haaf, T. (2017) · Clinical Epigenetics · doi:10.1186/s13148-017-0329-3 · Cited by 118 · see citing works
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Regulation of Maternal Metabolism by Pituitary and Placental Hormones: Roles in Fetal Development and Metabolic Programming
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Perspectives in Gestational Diabetes Mellitus: A Review of Screening,Diagnosis, and Treatment
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Non-Coding RNA: Role in Gestational Diabetes Pathophysiology and Complications
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Genetics of Gestational Diabetes Mellitus and Maternal Metabolism
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Short- and long-term consequences for offspring exposed to maternal diabetes: a review
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Circulating microRNA (miRNA) Expression Profiling in Plasma of Patients with Gestational Diabetes Mellitus Reveals Upregulation of miRNA miR-330-3p
Sebastiani, G., Guarino, E., Grieco, G. E., Formichi, C., Poggi, C. D., Ceccarelli, E., & Dotta, F. (2017) · Frontiers in Endocrinology · doi:10.3389/fendo.2017.00345 · Cited by 88 · see citing works
Nutrition therapy within and beyond gestational diabetes
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Precision nutrition and the microbiome part II: potential opportunities and pathways to commercialisation
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Treatments for women with gestational diabetes mellitus: an overview of Cochrane systematic reviews
Martis, R., Brown, J., Alsweiler, J. M., Downie, M. R., & Crowther, C. A. (2016) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd012327 · Cited by 85 · see citing works
An Unbiased Lipidomics Approach Identifies Early Second Trimester Lipids Predictive of Maternal Glycemic Traits and Gestational Diabetes Mellitus
Lu, L., Koulman, A., Petry, C. J., Jenkins, B., Matthews, L., Hughes, I. A., Acerini, C. L., Ong, K. K., & Dunger, D. B. (2016) · Diabetes Care · doi:10.2337/dc16-0863 · Cited by 88 · see citing works
Cholesterol cholelithiasis in pregnant women: pathogenesis, prevention and treatment
de Bari, O., Wang, T. Y., Liu, M., Paik, C. N., Portincasa, P., & Wang, D. Q. ‐. (2014) · Annals of Hepatology · doi:10.1016/s1665-2681(19)30975-5 · Cited by 88 · see citing works
Pregnancy‐induced changes in β‐cell function: what are the key players?
Salazar‐Petres, E., & Sferruzzi-Perri, A. N. (2021) · The Journal of Physiology · doi:10.1113/jp281082 · Cited by 89 · see citing works
Multifactorial Basis and Therapeutic Strategies in Metabolism-Related Diseases
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Authors: Di Cianni, G., Miccoli, R., Volpe, L., Lencioni, C., & Del Prato, S.
Affiliations: University of Pisa (IT)
ORCID: Miccoli, R.
Venue: Diabetes/Metabolism Research and Reviews
Publisher: Wiley
Published: 2003-07
Volume: 19
Issue: 4
Pages: 259-270
ISSN: 1520-7552 (ISSN-L)
1520-7560
DOI: 10.1002/dmrr.390
OpenAlex: W2129752055
Cited by: 406
References: 129
Citations by year: 2026: 13 · 2025: 18 · 2024: 26 · 2023: 29 · 2022: 30 · 2021: 44 · 2020: 40 · 2019: 24 · 2018: 26 · 2017: 18 · 2016: 21 · 2015: 14 · 2014: 12 · 2013: 10 · 2012: 12
FWCI: 1.40
Type: journal article
Language: en
Open access: closed
Licence: onlinelibrary.wiley.com/termsAndConditions#vor (vor, 10 d)
Locations: Diabetes/Metabolism Research and Reviews (publishedVersion)
PubMed (publishedVersion)
CINECA IRIS Institutial research information system (University of Pisa) (submittedVersion)
Topics: Health Sciences › Medicine › Obstetrics and Gynecology › Gestational Diabetes Research and Management
Health Sciences › Medicine › Surgery › Pancreatic function and diabetes
Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Birth, Development, and Health
Keywords: gestational diabetes mellitus, intermediary metabolism, pregnancy, glucose homeostasis, insulin resistance, insulin secretion, maternal hyperglycemia, type 2 diabetes risk, metabolic syndrome, maternal and neonatal morbidity, postpartum follow-up
MeSH terms: Female, Glucose, Homeostasis, Hormones, Humans, Insulin, Pregnancy, Reference Values, Diabetes, Gestational

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Intermediate metabolism in normal pregnancy and in gestational diabetes

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