Intermediate metabolism in association with the amino acid profile during the third trimester of normal pregnancy and diet-controlled gestational diabetes

In gestational diabetes, ketogenic amino acids and the branched-chain amino acid isoleucine are released at low rates from skeletal muscle and are mostly catabolized in the liver rather than in peripheral tissues. In contrast, in normal pregnancy proteinolysis is enhanced, and the ketogenic amino acids along with branched-chain amino acids are catabolized in both the liver and peripheral tissues. As a result, ketogenic amino acids are fully oxidized and gluconeogenesis becomes more efficient, whereas urea cycle operates at a higher rate.