Molecular pathways and nutrigenomic review of insulin resistance development in gestational diabetes mellitus

Abstract

Gestational diabetes mellitus is a condition marked by raised blood sugar levels and insulin resistance that usually occurs during the second or third trimester of pregnancy. According to the World Health Organization, hyperglycemia affects 16.9% of pregnancies worldwide. Dietary changes are the primarily alternative treatment for gestational diabetes mellitus. This paper aims to perform an exhaustive overview of the interaction between diet, gene expression, and the metabolic pathways related to insulin resistance. The intake of foods rich in carbohydrates can influence the gene expression of glycolysis, as well as foods rich in fat, can disrupt the beta-oxidation and ketogenesis pathways. Furthermore, vitamins and minerals are related to inflammatory processes regulated by the TLR4/NF-κB and one carbon metabolic pathways. We indicate that diet regulated gene expression of PPARα, NOS, CREB3L3, IRS, and CPT I, altering cellular physiological mechanisms and thus increasing or decreasing the risk of gestational diabetes. The alteration of gene expression can cause inflammation, inhibition of fatty acid transport, or on the contrary help in the modulation of ketogenesis, improve insulin sensitivity, attenuate the effects of glucotoxicity, and others. Therefore, it is critical to comprehend the metabolic changes of pregnant women with gestational diabetes mellitus, to determine nutrients that help in the prevention and treatment of insulin resistance and its long-term consequences.

Risk factors and genetic characteristics of the carriage of hypervirulent and carbapenem-resistant Acinetobacter baumannii among pregnant women

“…It has previously been revealed that diabetes could destroy the control relationships between bacteria, disrupting the human micro-ecological balance, which is conducive to forming pan-resistant species of AB ( Ren et al, 2019 ). The number of pregnant women with pre-existing diabetes was relatively low in the present study, whereas GDM was found to be an independent risk factor for pregnant women who carried the CRAB isolates; GDM also resulted in an increased risk of complications, such as leading to the development of type 2 diabetes in both the mother and infant ( Guevara-Ramírez et al, 2023 ). Infections in pregnancy are common and are associated with numerous consequences for the mother, fetus, and neonate ( Hazenberg et al, 2021 ).…”

Obesity and Obesity-Related Thyroid Dysfunction: Any Potential Role for the Very Low-Calorie Ketogenic Diet (VLCKD)?

“…A recent study by Verde and colleagues demonstrated that strict adherence to the Mediterranean diet prior to starting a VLCKD increases the effectiveness of the VLCKD by helping overweight/obesity-afflicted individuals to lose weight while enhancing their body composition [49]. The authors attributed these outcomes to the existence of bioactive compounds in the Mediterranean diet that may aid in creating an ideal metabolic environment for initiating ketosis [49][50][51][52]. It is noteworthy that the last phase (maintenance stage) of the VLCKD diet is a Mediterranean-style dietary approach [4…”