tipstipskehamilan. Pathophysiology gestational diabetes mellitus is the study of the physiological changes during pregnancy result in impaired glucose tolerance which develop gestational diabetes mellitus (GDM). The physiological changes during pregnancy are caused by changes in insulin level or insulin resistance as a decrease in its blood level that cause hyperglycemia and finally gestational diabetes mellitus.
In the pathophysiology of gestational diabetes mellitus we learn to understand the physiological changes mainly the endocrine changes during pregnancy in the feto-placental unit, which might explain the development of insulin resistance and GDM. In the pathophysiology of GDM we can also learn to understand role of the adipose tissue in gestational diabetes mellitus.
The placenta supplies a growing fetus with nutrients and water. It also produces a variety of hormones to maintain the pregnancy. A result of the normal secretion of several placental hormones, including placental growth hormone, placental lactogen, progesterone, and corticotropin-releasing hormone, which stimulates the production of adrenocorticotropic hormone (ACTH) in the pituitary gland and cortisol in the adrenal glands impede with the body's natural response to insulin, which results in a condition referred to as "insulin resistance".
As pregnancy progresses and the placenta grow larger, hormone production also increases and so does the level of insulin resistance. This process usually starts between 20 and 24 weeks of pregnancy.
In some cases, insulin resistance is increased by excessive weight gain during pregnancy. If insulin secretion does not increase sufficiently to counter the insulin resistance imposed by these changes, gestational diabetes occurs.