Summary:
In the course of pregnancy increasing insulin resistance develops due to deteriorated phosphorylation
of the insulin receptor and its substrate (IRS-1). As a result of relations between secretion
and the action of insulin the beta-cell reacts by insulin hypersecretion and thus the development
of hyperinsulinaemia is influenced. Furthermore pregnancy is characterized by increasing differences
between the anabolic and catabolic stage in the intermediary metabolism manifested in
particular by a tendency towards ketosis and hypoglycaemia during fasting and also by hypoaminoacidaemia.
In addition to these metabolic changes there are also other laboratory deviations,
manifested e.g. by hyperfibrinogenaemia and an increased concentration of tPA inhibitor (PAI-1)
without detectable endothelial dysfunction. The increasing albuminuria is not a manifestation of
developing nephropathy but the sign of functional changes which after delivery disappear very
quickly. The mentioned deviations are the consequence of altered hormonal regulations in the
course of pregnancy, while after delivery the baseline state present before pregnancy is restored.
Key words:
Pregnancy - Insulin resistance - Hyperinsulinaemia - Ketone bodies - Hypoaminoacidaemia
- Albuminuria
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