How does diabetes affect the woman and how does it happen during pregnancy?
During pregnancy, there are high circulating levels of several hormones that are antagonistic to insulin action including hPL, GH, and Prl. These can result in maternal insulin resistance, which results in decreased maternal glucose utilization. If maternal glucose uptake is reduced, circulating glucose levels can increase, and glucose readily crosses the placenta into the fetal circulation. In the fetus, the elevated glucose stimulates the fetal pancreas to produce insulin, and insulin levels are elevated in the fetal circulation. In the fetus, insulin is an important growth factor but cannot control glucose levels partly because of the continuous supply of elevated glucose from the maternal circulation. In uncontrolled gestational diabetes, infants are often larger for their gestational age than in unaffected individual