Clinical review for general practice

ISSN (Print) 2713-2552
ISSN (Online) 2782-5671
  • Home
  • about
  • archives
  • contacts
left
FULLSCREEN > Archive > 2024 > Vol 5, №4 (2024) > Modern ideas about the pathogenesis of gestational diabetes mellitus

Modern ideas about the pathogenesis of gestational diabetes mellitus

Mohamed L. Leffad , Nadezhda M. Startseva , Said M. Semiatov , Nadiya K. Kizima , Milana H. Mashtagova

For citation:


  • Abstract
  • About the Author
  • References

Abstract

Aim. Gestational diabetes mellitus (GDM) is by far the most common type of metabolic disorder in pregnant women, the consequences of which are significant for doctors of various specialties. Features of the course of GDM determine a whole range of completely new problems associated with the health of newborns. This was influenced, on the one hand, by the obesity pandemic, which provoked an exponential increase in the incidence of GDM, and insulin resistance, responsible for the earlier onset of GDM, and on the other hand, by the introduction into clinical practice of clear unified diagnostic criteria adopted by major international medical associations. As the prevalence of GDM continues to increase, the development of new prognostic and diagnostic tests for this pregnancy-associated condition is of great importance to improve outcomes for both mothers and children.
Purpose. To study modern ideas about the pathogenesis of GDM.
Material and methods. To write this review, a search was carried out for domestic and foreign publications in Russian and international search systems (PubMed, eLibrary, etc.) over the past 9 years. The review included articles from the peer-reviewed literature.
Results. The review presents data on various mechanisms of GDM occurrence.
Conclusion. Thus, GDM is a growing public health problem associated with rising obesity. To minimize complications for mother and baby, early diagnosis is essential. However, ideal screening for GDM has not yet been developed. The studies discussed in this review highlight the seriousness of GDM, including identifying and managing risk factors, accurately diagnosing and treating the disease to prevent associated complications.
Keywords: gestational diabetes mellitus, interleukins, microbiota, thyroid gland, diet.

About the Author

Mohamed L. Leffad 1 , Nadezhda M. Startseva 1 , Said M. Semiatov 1 , Nadiya K. Kizima 2 , Milana H. Mashtagova 3

1 Patrice Lumumba People’s Friendship University of Russia, Moscow, Russia

2 Patrice Lumumba People’s Friendship University of Russia, Moscow, Russia; Center of Biotic Medicine, Moscow, Russia

3 Moscow Multidisciplinary Clinical Center "Kommunarka", Moscow, Russia

References

1. Mustad VA, Huynh DTT, López-Pedrosa JM et al. The Role of Dietary Carbohydrates in Gestational Diabetes. Nutrients 2020;12(2):385. DOI: 10.3390/nu12020385
2. Cho NH, Shaw JE, Karuranga S et al. IDF Diabetes Atlas: Global estimates of diabetes prevalence for 2017 and projections for 2045. Diabetes Res Clin Pract 2018;(138):271-81.
3. Schoenaker DA, Mishra GD, Callaway LK, Soedamah-Muthu SS. The Role of Energy, Nutrients, Foods, and Dietary Patterns in the Development of Gestational Diabetes Mellitus: A Systematic Review of Observational Studies. Diabetes Care 2016;39(1):16-23. DOI: 10.2337/dc15-0540
4. Herrera E, Desoye G. Maternal and fetal lipid metabolism under normal and gestational diabetic conditions. Horm Mol Biol Clin Investig 2016;(26):109-27.
5. Vilotić A, Nacka-Aleksić M, Pirković A et al. IL-6 and IL-8: An Overview of Their Roles in Healthy and Pathological Pregnancies. Int J Mol Sci 2022;23(23):14574. DOI: 10.3390/ijms232314574
6. Tang M, Luo M, Lu W et al. Nerve Growth Factor Is Closely Related to Glucose Metabolism, Insulin Sensitivity and Insulin Secretion in the Second Trimester: A Case-Control Study in Chinese. Nutr Metab 2020;(17):98.
7. Siddiqui S, Waghdhare S, Goel C et al. Augmentation of IL-6 Production Contributes to Development of Gestational Diabetes Mellitus: An Indian Study. Diabetes Metab Syndr Clin Res Rev 2019;(13):895-9.
8. Keckstein S, Pritz S, Amann N et al. Sex Specific Expression of Interleukin 7, 8 and 15 in Placentas of Women with Gestational Diabetes. Int J Mol Sci 2020;(21):8026.
9. Toljic M, Nikolic N, Joksic I et al. Expression of miRNAs and proinflammatory cytokines in pregnant women with gestational diabetes mellitus.
J Reprod Immunol 2024;162:104211. DOI: 10.1016/j.jri.2024.104211
10. Cao W et al. Maternal lipids, BMI and IL-17/IL-35 imbalance in concurrent gestational diabetes mellitus and preeclampsia. Exp Ther Med 2018.
11. Abell SK, De Courten B, Boyle JA, Teede HJ. Inflammatory and Other Biomarkers: Role in Pathophysiology and Prediction of Gestational Diabetes Mellitus. Int J Mol Sci 2015;(16):13442-73.
12. Crusell MKW, Hansen TH, Nielsen T et al. Gestational diabetes is associated with change in the gut microbiota composition in third trimester of pregnancy and postpartum. Microbiome 2018;(6):89.
13. Fugmann M, Breier M, Rottenkolber M et al. The stool microbiota of insulin resistant women with recent gestational diabetes, a high risk group for type 2 diabetes. Sci Rep 2015;(5):13212.
14. Li D, Wang P, Wang P et al. The gut microbiota: A treasure for human health. Biotechnol Adv 2016;(34):1210-24.
15. Gohir W, Whelan FJ, Surette MG et al. Pregnancy-related changes in the maternal gut microbiota are dependent upon the mother’s periconceptional diet. Gut Microbes 2015;(6):310-20.
16. Dualib PM, Ogassavara J, Mattar R et al. Gut microbiota and gestational Diabetes Mellitus: A systematic review. Diabetes Res Clin Pract 2021;(180):109078.
17. Obuchowska A, Gorczyca K, Standyło A et al. Effects of Probiotic Supplementation during Pregnancy on the Future Maternal Risk of Metabolic Syndrome. Int J Mol Sci 2022;(23):8253.
18. Cortez RV, Taddei CR, Sparvoli LG et al. Microbiome and its relation to gestational diabetes. Endocrine 2019;(64):254-64.
19. Ponzo V, Fedele D, Goitre I et al. Diet-Gut Microbiota Interactions and Gestational Diabetes Mellitus (GDM). Nutrients 2019;(11):330.
20. Pérez-Pérez A, Vilariño-García T, Guadix P et al. Leptin and Nutrition in Gestational Diabetes. Nutrients 2020;12(7):1970. DOI: 10.3390/nu 12071970
21. Silke C, Marie-Christine S. Microbial Regulation of Glucose Metabolism and Insulin Resistance. Genes 2018;(9):10.
22. Ren Y, Zeng Y, Wu Y et al. The Role of Gut Microbiota in Gestational Diabetes Mellitus Affecting Intergenerational Glucose Metabolism: Possible Mechanisms and Interventions. Nutrients 2023;15(21):4551. DOI: 10.3390/nu15214551
23. Yuste Gómez A, Ramos Álvarez MDP, Bartha JL. Influence of Diet and Lifestyle on the Development of Gestational Diabetes Mellitus and on Perinatal Results. Nutrients 2022;14(14):2954. DOI: 10.3390/nu14142954
24. Springer D, Jiskra J, Limanova Z et al. Thyroid in pregnancy: from physiology to screening. Crit Rev Clin Lab Sci 2017;54(2):102-16.
25. Jabbar A, Pingitore A, Pearce SH et al. Thyroid hormones and cardiovascular disease. Nat Rev Cardiol 2017;14(1):39-55.
26. Jing S, Xiaoying D, Ying X et al. Different levels of thyroid hormones between impaired fasting glucose and impaired glucose tolerance: free T3 affects the prevalence of impaired fasting glucose and impaired glucose tolerance in opposite ways. Clin Endocrinol (Oxf) 2014;80(6):890-8.
27. Lee SY, Cabral HJ, Aschengrau A, Pearce EN. Associations Between Maternal Thyroid Function in Pregnancy and Obstetric and Perinatal Outcomes. J Clin Endocrinol Metab 2020;105(5):e2015-23. DOI: 10.1210/clinem/dgz275
28. Gietka-Czernel M, Glinicki P. Subclinical hypothyroidism in pregnancy: controversies on diagnosis and treatment. Pol Arch Intern Med 2021;131(3):266‐75.
29. Mavromati M, Jornayvaz FR. Hypothyroidism-associated dyslipidemia: potential molecular mechanisms leading to NAFLD. Int J Mol Sci 2021;22(23):12797.
30. Vrijkotte TG, Hrudey EJ, Twickler MB. Early maternal thyroid function during Gestation is Associated with fetal growth, particularly in male newborns. J Clin Endocrinol Metab 2017;102(3):1059-66.
31. Du MK, Ge LY, Zhou ML et al. Effects of pre-pregnancy body mass index and gestational weight gain on neonatal birth weight. J Zhejiang Univ Sci B 2017;18(3):263-71.
32. Ittermann T, Schipf S, Dorr M et al. Hyperthyroxinemia is positively associated with prevalent and incident type 2 Diabetes Mellitus in two population-based samples from Northeast Germany and Denmark.
Nutr Metab Cardiovasc Dis 2018;28(2):173-9.
33. Chen GD, Gou XY, Pang TT et al. Associations between thyroid function and gestational Diabetes Mellitus in Chinese pregnant women: a retrospective cohort study. BMC Endocr Disord 2022;22(1):44.
34. Furnica RM, Gruson D, Lazarus JH et al. First trimester isolated maternal hypothyroxinaemia: adverse maternal metabolic profile and impact on the obstetrical outcome. Clin Endocrinol (Oxf) 2017;86(4):576-83.
35. Леффад М.Л., Старцева Н.М., Семятов С.М. и др. Гестационный сахарный диабет ассоциирован с субклиническим гипотиреозом. Материнские и перинатальные исходы. Акушерство и гинекология. 2023;11(3):17-23. DOI: 10.33029/2303-9698-2023-11-3-17-23
Leffad M.L., Startseva N.M., Semyatov S.M. and others. Gestational diabetes mellitus is associated with subclinical hypothyroidism. Maternal and perinatal outcomes. Obstetrics and gynecology. 2023;11(3):17-23. DOI: 10.33029/2303-9698-2023-11-3-17-23 (in Russian).
36. Luo J, Wang X, Yuan L, Guo L. Association of thyroid disorders with gestational diabetes mellitus: a meta-analysis. Endocrine 2021;73(3):550-60. DOI: 10.1007/s12020-021-02712-2
37. Lee SY, Cabral HJ, Aschengrau A, Pearce EN. Associations Between Maternal Thyroid Function in Pregnancy and Obstetric and Perinatal Outcomes. J Clin Endocrinol Metab 2020;105(5):e2015-23. DOI: 10.1210/clinem/dgz275
38. Safian S, Esna-Ashari F, Borzouei S. Thyroid Dysfunction in Pregnant Women with Gestational Diabetes Mellitus. Curr Diabetes Rev 2020;16(8):895-9. DOI: 10.2174/1573399816666191223111833
39. Li F, Hu Y, Zeng J et al. Analysis of risk factors related to gestational diabetes mellitus. Taiwan J Obstet Gynecol 2020;59(5):718-22. DOI: 10.1016/j.tjog.2020.07.016
40. Huang K, Su S, Wang X et al. Association Between Maternal Thyroid Function in Early Pregnancy and Gestational Diabetes: A Prospective Cohort Study. J Clin Endocrinol Metab 2024;109(2):e780-e787. DOI: 10.1210/clinem/dgad518
41. Dubey P, Thakur V, Chattopadhyay M. Role of Minerals and Trace Elements in Diabetes and Insulin Resistance. Nutrients 2020;12(6):1864. DOI: 10.3390/nu12061864
42. Wolide AD, Zawdie B, Alemayehu T, Tadesse S. Association of trace metal elements with lipid profiles in type 2 diabetes mellitus patients: A cross sectional study. BMC Endocr Disord 2017;(17):64. DOI: 10.1186/s12902-017-0217-z
43. Sun W, Yang J, Wang W et al. The beneficial effects of Zn on Akt-mediated insulin and cell survival signaling pathways in diabetes. J Trace Elements Med Boil 2018;(46):117-27. DOI: 10.1016/j.jtemb.2017.12.005
44. Zhang Q, Sun X, Xiao X et al. Dietary Chromium Restriction of Pregnant Mice Changes the Methylation Status of Hepatic Genes Involved with Insulin Signaling in Adult Male Offspring. PLoS One 2017;12:e0169889. DOI: 10.1371/journal.pone.0169889.
45. Tinkov AA, Sinitskii A, Popova E et al. Alteration of local adipose tissue trace element homeostasis as a possible mechanism of obesity-related insulin resistance. Med Hypotheses 2015;(85):343-7. DOI: 10.1016/j.mehy.2015.06.005
46. Сокур Т.Н., Дубровина Н.В. Витамины и минералы: значимость приема во время беременности. Гинекология. 2015;17(6).
Sokur T.N., Dubrovina N.V. Vitamins and minerals: the importance of taking them during pregnancy. Gynecology. 2015;17(6) (in Russian).
47. Oh C, Keats EC, Bhutta ZA. Vitamin and Mineral Supplementation During Pregnancy on Maternal, Birth, Child Health and Development Outcomes in Low- and Middle-Income Countries: A Systematic Review and Meta-Analysis. Nutrients 2020;12(2):491. DOI: 10.3390/ nu12020491
48. Zhang M-X, Pan G-T, Guo J-F et al. Vitamin D Deficiency Increases the Risk of Gestational Diabetes Mellitus: A Meta-Analysis of Observational Studies. Nutrients 2015;(7):8366-75.
49. Parast VM, Paknahad Z. Antioxidant Status and Risk of Gestational Diabetes Mellitus: A Case-Control Study. Clin Nutr Res 2017;6:81-8.
50. Bartáková V, Pleskačová A, Kuricová K et al. Dysfunctional protection against advanced glycation due to thiamine metabolism abnormalities in gestational diabetes. Glycoconj J 2016;(33):591-8.
51. Sukumar N, Venkataraman H, Wilson S et al. Vitamin B12 Status among Pregnant Women in the UK and Its Association with Obesity and Gestational Diabetes. Nutrients 2016;(8):768.
52. Bo S, Lezo A, Menato G et al. Gestational hyperglycemia, zinc, selenium, and antioxidant vitamins. Nutrition 2005;(21):186-91.
53. Boyle VT, Thorstensen EB, Mourath D et al. The relationship between 25-hydroxyvitamin D concentration in early pregnancy and pregnancy outcomes in a large, prospective cohort. Br J Nutr 2016;(116):1409-15.
54. Jamilian M, Mirhosseini N, Eslahi M et al. The effects of magnesium-zinc-calcium-vitamin D co-supplementation on biomarkers of inflammation, oxidative stress and pregnancy outcomes in gestational diabetes. BMC Pregnancy Childbirth 2019;19(1):107. DOI: 10.1186/ s12884-019-2258-y
55. Hamdan HZ, Hamdan SZ, Adam I. Association of Selenium Levels with Gestational Diabetes Mellitus: An Updated Systematic Review and Meta-Analysis. Nutrients 2022;14(19):3941. DOI: 10.3390/nu 14193941
56. Yao X, Liu R, Li X et al. Zinc, selenium and chromium co-supplementation improves insulin resistance by preventing hepatic endoplasmic reticulum stress in diet-induced gestational diabetes rats. J Nutr Biochem 2021;(96):108810. DOI: 10.1016/j.jnutbio.2021.108810
57. Yang K, Yang Y, Pan B et al. Relationship between iron metabolism and gestational diabetes mellitus: A systemic review and meta analysis. Asia Pac J Clin Nutr 2022;31(2):242-54. DOI: 10.6133/apjcn. 202206_31(2).0010
58. Petry CJ. Iron Supplementation in Pregnancy and Risk of Gestational Diabetes: A Narrative Review. Nutrients 2022;14(22):4791. DOI: 10.3390/nu14224791
59. American Diabetes Association 13. Management of Diabetes in Pregnancy. Diabetes Care 2017;(40):S114-S119.
60. Rasmussen L, Poulsen CW, Kampmann U et al. Diet and Healthy Lifestyle in the Management of Gestational Diabetes Mellitus. Nutrients 2020;12(10):3050. DOI: 10.3390/nu12103050
61. Yisahak SF, Hinkle SN, Mumford SL et al. Vegetarian diets during pregnancy, and maternal and neonatal outcomes. Int J Epidemiol 2021;50(1):165-78. DOI: 10.1093/ije/dyaa200
62. Quan W, Zeng M, Jiao Y et al. Western Dietary Patterns, Foods, and Risk of Gestational Diabetes Mellitus: A Systematic Review and Meta-Analysis of Prospective Cohort Studies. Adv Nutr 2021;12(4):1353-64. DOI: 10.1093/advances/nmaa184

For citation:Leffad M.L., Startseva N.M., Semiatov S.M., Kizima N.K., Mashtagova M.H. Modern ideas about the pathogenesis of gestational diabetes mellitus. Clinical review for general practice. 2024; 5 (4): 71–75 (In Russ.). DOI: 10.47407/kr2024.5.4.00421


All accepted articles publish licensed under a Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0) which allows users to read, copy, distribute and make derivative works for non-commercial purposes from the material, as long as the author of the original work is cited properly.

  • About
  • Editorial board
  • Ethics
  • For authors
  • Author fees
  • Peer review
  • Contacts

oa
crossref
анри


  Indexing

doaj
elibrary

Address of the Editorial Office:

127055, Moscow, s/m 37

Correspondence address:

115054, Moscow, Zhukov passage, 19, fl. 2, room XI


Managing Editor:

+7 (495) 926-29-83

id@con-med.ru