» Articles » PMID: 38812661

The Placental Role in Gestational Diabetes Mellitus: A Molecular Perspective

Abstract

During pregnancy, women undergo several metabolic changes to guarantee an adequate supply of glucose to the foetus. These metabolic modifications develop what is known as physiological insulin resistance. When this process is altered, however, gestational diabetes mellitus (GDM) occurs. GDM is a multifactorial disease, and genetic and environmental factors play a crucial role in its aetiopathogenesis. GDM has been linked to both macroscopic and molecular alterations in placental tissues that affect placental physiology. This review summarizes the role of the placenta in the development of GDM from a molecular perspective, including hormonal and pro-inflammatory changes. Inflammation and hormonal imbalance, the characteristics dominating the GDM microenvironment, are responsible for placental changes in size and vascularity, leading to dysregulation in maternal and foetal circulations and to complications in the newborn. In conclusion, since the hormonal mechanisms operating in GDM have not been fully elucidated, more research should be done to improve the quality of life of patients with GDM and their future children.

Citing Articles

Unveiling Gestational Diabetes: An Overview of Pathophysiology and Management.

Mittal R, Prasad K, Lemos J, Arevalo G, Hirani K Int J Mol Sci. 2025; 26(5).

PMID: 40076938 PMC: 11900321. DOI: 10.3390/ijms26052320.


Genetic and epigenetic alterations associated with gestational diabetes mellitus and adverse neonatal outcomes.

Shamsad A, Gautam T, Singh R, Banerjee M World J Clin Pediatr. 2025; 14(1):99231.

PMID: 40059904 PMC: 11686586. DOI: 10.5409/wjcp.v14.i1.99231.


Air Pollution Exposure and Gestational Diabetes Mellitus Risk: A Retrospective Case-Control Study with Multi-Pollutant Analysis in Wuhan, Hubei Province.

Dai M, Liu J, Hu M, Zhang F, Wang Y, Dai F Toxics. 2025; 13(2).

PMID: 39997956 PMC: 11860625. DOI: 10.3390/toxics13020141.


Impact of Gestational Diabetes Mellitus on Fetal Growth and Nutritional Status in Newborns.

Karcz K, Krolak-Olejnik B Nutrients. 2024; 16(23).

PMID: 39683486 PMC: 11643953. DOI: 10.3390/nu16234093.


Cellular and Molecular Pathophysiology of Gestational Diabetes.

Torres-Torres J, Monroy-Munoz I, Perez-Duran J, Solis-Paredes J, Camacho-Martinez Z, Baca D Int J Mol Sci. 2024; 25(21).

PMID: 39519193 PMC: 11546748. DOI: 10.3390/ijms252111641.


References
1.
Yang Y, Guo F, Peng Y, Chen R, Zhou W, Wang H . Transcriptomic Profiling of Human Placenta in Gestational Diabetes Mellitus at the Single-Cell Level. Front Endocrinol (Lausanne). 2021; 12:679582. PMC: 8139321. DOI: 10.3389/fendo.2021.679582. View

2.
OSullivan J . Diabetes mellitus after GDM. Diabetes. 1991; 40 Suppl 2:131-5. DOI: 10.2337/diab.40.2.s131. View

3.
Hayes Ryan D, McCarthy F, ODonoghue K, Kenny L . Placental growth factor: A review of literature and future applications. Pregnancy Hypertens. 2018; 14:260-264. DOI: 10.1016/j.preghy.2018.03.003. View

4.
Shang M, Wen Z . Increased placental IGF-1/mTOR activity in macrosomia born to women with gestational diabetes. Diabetes Res Clin Pract. 2018; 146:211-219. DOI: 10.1016/j.diabres.2018.10.017. View

5.
Chauhan M, Balakrishnan M, Chan R, Yallampalli C . Adrenomedullin 2 (ADM2) Regulates Mucin 1 at the Maternal-Fetal Interface in Human Pregnancy. Biol Reprod. 2015; 93(6):136. PMC: 4712695. DOI: 10.1095/biolreprod.115.134296. View