Pathophysiological Features of Glucose Metabolism in the Fetus with Diabetes Mellitus

Abstract

During pregnancy with diabetes mellitus (DM), the fetus undergoes many metabolic changes. The extent of these changes depends not only on the level of maternal glycemia, but also on the level of fetal glycemia. Other important alternating factors are fetal hyperinsulinemia and disturbances in the functioning of transporters of various substances. Most structural changes occur in the fetal part of the placenta. This is manifested by a thickening of the basement membrane, a decrease in the number of syncytiotrophoblast microvilli, disruption of the activity of various transport proteins and, as a consequence, a change in the cascade of all metabolic reactions. Literature data on the pathophysiological features of glucose metabolism in the fetus with diabetes mellitus were analyzed.