Modulations physiologiques et immunologiques au cours du diabète gestationnel et de la macrosomie : implication d'une programmation in utero et nouveau concept de « mémoire métabolique »

Gestational diabetes frequently results in macrosomia and fetal obesity. The aim of this review is to shed a light on the actual knowledge on the implication of the new concept of ''metabolic memory'' created during gestational diabetes on the onset of metabolic diseases in adulthood in macrosomic offspring. Several studies have shown that the abnormalities in carbohydrate and lipid metabolism in macrosomic newborns of diabetic mothers are due to maternal hyperglycemia, which leads to fetal hyperinsulinemia. We have developed a rat model of macrosomic offspring and assessed the onset of obesity in these animals. The macrosomic newborns of diabetic mothers are prone to develop glucose intolerance, insulin resistance and obesity as a function of age. Besides, T cells isolated from gestational diabetic rats and their macrosomic offspring seem to present a defect in immunity signal transduction. Finally, it seems that in utero programming during diabetic pregnancy generates a “metabolic memory” which could be responsible for the development of obesity in macrosomic offspring and the onset of metabolic diseases in adulthood.