Adaptations métaboliques au cours de la grossesse

During gestation, women undergo a modification of their energetic and nutritional metabolism to redirect part of the substrates to the growing fetus. A key event in this metabolic adaptation is the development of an insulin resistant state that is triggered by several maternal hormones produced by the placenta and the pituitary gland as well as by adipokines and cytokines. The reduced insulin sensitivity of maternal tissues favors the transport of nutrients from the maternal plasma to the fetus. The insulin resistant state results in a rise in the insulin needs of the mother that is compensated by an increase in the number and in the secretory activity of pancreatic beta cells, permitting to maintain blood glucose homeostasis. Here, we provide a general overview of these adaptive processes and highlight the molecular and cellular mechanisms responsible of the functional adaptation of beta cells during pregnancy.