Insulin and the placenta in GDM

Abstract

Placental development and function are tightly regulated by endocrine, paracrine, and autocrine factors present in the maternal and the fetal circulation and in the placenta. Gestational diabetes (GDM) is associated with a derangement of the concentration of several hormones, cytokines, metabolites, and growth factors in both circulations that may subsequently alter placental morphology and function. One of these is the peptide hormone insulin, which exerts pleiotropic effects on target cells. The placenta is very rich in receptors for insulin and insulin-like growth factors (IGFs) and is therefore susceptible to their concentration changes. This chapter describes general placental alterations in GDM and particularly focuses on the effects of insulin and its signalling components on the placenta. © 2010 Springer-Verlag London Limited.