Title of project

Lipid insulin sensitivity in pregnant women with GDM and consequences for their offspring

Abstract

The prevalence of gestational diabetes mellitus (GDM) is rising both globally and nationally, now affecting up to 14% of pregnancies. GDM is associated with short- and long-term complications for both mother and child, including increased risks of preeclampsia, cesarean section, macrosomia, neonatal hypoglycemia, and the later development of type 2 diabetes mellitus (T2DM). Current treatment primarily involves dietary modification, with insulin therapy initiated when glycemic targets are not met. However, despite improved maternal glucose control, neonatal outcomes, particularly large for gestational age (LGA) , remain a concern. While the Pedersen hypothesis attributes fetal macrosomia in GDM to maternal hyperglycemia, stimulating fetal insulin production, emerging evidence indicates that non-glycemic factors, particularly high levels of maternal lipids due to increased insulin resistance, play a significant role in fetal growth. This is especially relevant in pregnancies complicated by maternal overweight, obesity, and GDM.
This PhD project aims to investigate maternal lipid insulin sensitivity in pregnant women with normal weight (NW), in pregnant women with overweight or obesity (OW), and in women with GDM, and its association with neonatal fat accretion. We hypothesize a stepwise reduction in lipid insulin sensitivity from NW to OW to GDM, contributing significantly to fetal adiposity. The findings will enhance our understanding of GDM pathophysiology and support the development of novel, targeted interventions beyond glucose control.