Placental peptides regulating islet adaptation to pregnancy: clinical potential in gestational diabetes mellitus

Pregnancy involves a progressive increase in insulin resistance and the β-cells must adapt to compensate and prevent gestational diabetes (GDM). In this review we discuss the evidence for placental peptides, including placental lactogen, hepatocyte growth factor, adiponectin and leptin, playing a role in the islet adaptation to pregnancy. The difficulties of translating data from rodent models into human pregnancy are covered and we summarise studies investigating associations between serum placental peptides and GDM risk. In conclusion, current data support important roles for placental peptides interacting to support β-cells during pregnancy, however mechanisms involved in humans are unclear. Further work in humans is required, but placental peptides have clinical potential from both a diagnostic and therapeutic perspective.