Carbohydrate Metabolism in Pregnancy

Abstract

COMPELLING evidence that gestation taxes ma > ternal insulin economy is afforded by the usual clinical course in pregnant subjects with marginal or absent pancreatic reserve. Thus, in prediabetes, pregnancy may unmask chemical diabetes mellitus, and, in patients known to have the disease, pregnancy may increase the maintenance requirements for insulin.1 , 2 Previous work from this laboratory has indicated that augmented catabolism of insulin may contribute, at least in part, to these diabetogenic effects of gestation. It has been shown that all portions of the conceptus contain enzymatic mechanisms for the proteolytic inactivation of insulin,3 , 4 that maternal insulin has free access . . .