Body Mass Index and Insulin Sensitivity/Resistance: Cross Talks in Gestational Diabetes, Normal Pregnancy and Beyond

Abstract

Pregnancy is a complex of metabolic, physiological, biochemical, and immunological changes in women's body, usually reversible after delivery in normal pregnancy. Gestational diabetes mellitus (GDM) is defined as "any degree of glucose intolerance with onset or first recognition during the current pregnancy." The etiology of the GDM is multifactorial and not sufficiently elucidated. The overweight and obesity during prepregnancy and pregnancy are one of the main modifiable risk factors of GDM. Maternal obesity increases the risk of a number of pregnancy complications, adverse pregnancy outcome for mother and child, and related chronic conditions in women. The obesity prevalence is the greatest among children of obese mothers, and an independent association between maternal body mass index and offspring adiposity and insulin resistance exists. Although the underlying mechanism remains unclear, available evidence suggests that GDM pathogenesis is based on relatively diminished insulin secretion coupled with pregnancy-induced insulin resistance. Recent findings provide data that higher BMI leads to decreased insulin sensitivity and higher degree of insulin resistance and contributes to GDM development.