Beta-cell compensation and gestational diabetes

Usman, Taofeek O.; Chhetri, Goma; Yeh, Hsuan; Dong, H. Henry

doi:10.1016/j.jbc.2023.105405

Cited by 10 publications

(3 citation statements)

References 105 publications

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“…Although insulin resistance can be advantageous to the foetus because it directs glucose towards foetal growth [ 25 – 27 ], it can also have adverse effects if uncontrolled. Indeed, insulin resistance is associated with GDM [ 28 ] known to be linked to adverse pregnancy outcomes [ 29 ]. The GDM prevalence of 0.8% observed in the current study is lower than those of other studies.…”

Section: Discussionmentioning

confidence: 99%

Gestational glucose intolerance among pregnant women at the Cape Coast Teaching Hospital

Kumah,

Agbeno,

Derkyi-Kwarteng

et al. 2024

BMC Pregnancy Childbirth

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Background Malaria in pregnancy can have adverse outcomes if untreated. Both malaria and pregnancy are associated with insulin resistance and diabetes. Although malaria is treated prophylactically with gestational diabetes mellitus (GDM) screened for in pregnancy as part a routine antenatal care, their impacts have not been examined in terms of other forms of dysglycaemia. This cross-sectional study examined insulin resistance and its relationship with dysglycaemia and malaria among pregnant women in the Cape Coast Teaching Hospital (CCTH). Methods Using a structured questionnaire, demographic and clinical information were obtained from 252 pregnant women aged 18–42 years. Weight and height were measured for computation of body mass index (BMI). Measurement of insulin, lipid profile and glucose were taken under fasting conditions followed by oral glucose tolerant test. Insulin resistance and beta-cell function were assessed by the homeostatic model as malaria was diagnosed by microscopy. Results The respective prevalence of GDM, gestational glucose intolerance (GGI) and insulin resistance were 0.8% (2/252), 19.44% (49/252) and 56.75% (143/252). No malaria parasite or dyslipidaemia was detected in any of the participants. Apart from BMI that increased across trimesters, no other measured parameter differed among the participants. Junior High School (JHS) education compared with no formal education increased the odds (AOR: 2.53; CI: 1.12–5.71; P = 0.03) but 2nd trimester of pregnancy compared to the 1st decreased the odds (AOR: 0.32; CI: 0.12–0.81; P = 0.02) of having insulin resistance in the entire sample. In a sub-group analysis across trimesters, pregnant women with JHS education in their 3rd trimester had increased odds (AOR: 4.41; CI: 1.25–15.62; P = 0.02) of having insulin resistance. Conclusion Prevalence of GDM and GGI were 0.8% and 19.44% respectively. The odds of insulin resistance increased in pregnant women with JHS education in the 3rd trimester. Appropriate measures are needed to assuage the diabetogenic risk posed by GGI in our setting.

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Section: Discussionmentioning

confidence: 99%

Gestational glucose intolerance among pregnant women at the Cape Coast Teaching Hospital

Kumah,

Agbeno,

Derkyi-Kwarteng

et al. 2024

BMC Pregnancy Childbirth

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show abstract

“…The pathophysiology of GDM is multifactorial and involves both genetic predispositions and environmental triggers that contribute to its development. A key factor in the pathogenesis of GDM is insulin resistance [ 41 ], which is exacerbated during pregnancy due to hormonal changes, leading to inadequate insulin compensation and hyperglycemia.…”

Section: Discussionmentioning

confidence: 99%

Effect of arsenic on the risk of gestational diabetes mellitus: a systematic review and meta-analysis

Wu,

Duan,

Zong

et al. 2024

BMC Public Health

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Background Gestational diabetes mellitus (GDM) is a complication of pregnancy associated with numerous adverse outcomes. There may be a potential link between GDM and arsenic (As) exposure, but this hypothesis remains controversial. This meta-analysis summarizes the latest studies evaluating the association between As and GDM. Methods A comprehensive search of the PubMed, Embase, and Scopus databases up to September 2023 was performed. The pooled estimates with 95% CIs were presented using forest plots. Estimates were calculated with random effects models, and subgroup and sensitivity analyses were conducted to address heterogeneity. Results A total of 13 eligible studies involving 2575 patients with GDM were included in this meta-analysis. The results showed that women exposed to As had a significantly increased risk of GDM (OR 1.47, 95% CI: 1.11 to 1.95, P = 0.007). Subgroup analyses suggested that the heterogeneity might be attributed to the years of publication. In addition, sensitivity analysis confirmed the robust and reliable results. Conclusions This analysis suggested that women exposed to As have a greater risk of GDM. However, the significant heterogeneity across studies requires careful interpretation. Registration The PROSPERO registration ID is CRD42023461820.

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“…Hyperinsulinemia as a means of compensating for insulin resistance, through the pancreas β Cells release more insulin to cope with insulin resistance or metabolic stress 6 . Insufficient β-cell compensation for maternal insulin resistance contributes to reduced insulin secretion and impaired glucose tolerance, characteristic of GDM 7 .GDM may have an adverse effect on the health of mothers and offspring. Women with GDM are at an increased risk for experiencing pregnancy complications such as miscarriage, dystocia, preeclampsia, fetal malformations, perinatal macrosomia, and neonatal hypoglycemia 8 , 9 .…”

Section: Introductionmentioning

confidence: 99%

Glucose uptake in trophoblasts of GDM mice is regulated by the AMPK-CLUT3 signaling pathway

Xiao,

Liu,

Luan

et al. 2024

Sci Rep

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GDM, as a metabolic disease during pregnancy, regulates GLUT3 translocation by AMPK, thereby affecting glucose uptake in trophoblasts. It provides a new research idea and therapeutic target for alleviating intrauterine hyperglycemia in GDM. STZ was used to construct GDM mice, inject AICAR into pregnant mice, and observe fetal and placental weight; flow cytometry was employed for the detection of glucose uptake by primary trophoblast cells; immunofluorescence was applied to detect the localization of GLUT3 and AMPK in placental tissue; Cocofal microscope was used to detect the localization of GLUT3 in trophoblast cells;qRT-PCR and Western blot experiments were carried out to detect the expression levels of GLUT3 and AMPK in placental tissue; CO-IP was utilized to detect the interaction of GLUT3 and AMPK. Compared with the normal pregnancy group, the weight of the fetus and placenta of GDM mice increased (P < 0.001), and the ability of trophoblasts to take up glucose decreased (P < 0.001). In addition, AMPK activity in trophoblasts and membrane localization of GLUT3 in GDM mice were down-regulated compared with normal pregnant mice (P < 0.05). There is an interaction between GLUT3 and AMPK. Activating AMPK in trophoblasts can up-regulate the expression of GLUT3 membrane protein in trophoblasts of mice (P < 0.05) and increase the glucose uptake of trophoblasts (P < 0.05). We speculate that inhibition of AMPK activity in GDM mice results in aberrant localization of GLUT3, which in turn attenuates glucose uptake by placental trophoblast cells. AICAR activates AMPK to increase the membrane localization of GLUT3 and improve the glucose uptake capacity of trophoblasts.

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Beta-cell compensation and gestational diabetes

Cited by 10 publications

References 105 publications

Gestational glucose intolerance among pregnant women at the Cape Coast Teaching Hospital

Gestational glucose intolerance among pregnant women at the Cape Coast Teaching Hospital

Effect of arsenic on the risk of gestational diabetes mellitus: a systematic review and meta-analysis

Glucose uptake in trophoblasts of GDM mice is regulated by the AMPK-CLUT3 signaling pathway

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