As type 2 diabetes increases worldwide, so does the incidence of hyperglycemia during pregnancy, or gestational diabetes. In some populations, such as the Middle East, gestational diabetes may occur in half of the pregnancies. In most cases, the hyperglycemia resolves at delivery, although both the child and the mother remain at an increased risk of future diabetes. The hyperglycemia of gestational diabetes is driven in large part by the hormone production of the placenta, which increases insulin resistance, thus resulting in hyperglycemia in susceptible individuals. Thus it is fitting that the journal Placenta publishes this useful review of all of the factors hypothesized to be involved with fetal changes in utero, and continued metabolic changes over life. Methylation of specific genes in the fetus is driven by in utero glucose and insulin levels, and these changes are partly responsible for the increased risk of future diabetes. This makes preventing gestational diabetes very important, in addition to finding optimal ways to control glycemic control during a pregnancy to improve outcomes for the mother and the child.
See abstract here.