Inquiries into the Pathogenesis of Gestational Diabetes

Abstract

Except for insulin-dependent diabetes of acute onset, it is usually difficult to time the duration of glucose intolerance with any degree of accuracy. Gestational diabetes may be one of the few exceptions. Herein glucose homeostasis is challenged by increased requirements for insulin and contrainsulin hormones which exert their maximal impact by the end of the second trimester and persist unabated throughout the third. Consequently, glucose intolerance is first recognized between 24 and 32 weeks of gestation. Thus, pregnancy may be the ideal time in which to evaluate the determinants of early diabetogenesis in the “maturity onset” or “not insulin-dependent” type of diabetes.