Changes in carbohydrate metabolism during pregnancy include: 1) Increased production of anti-insulin hormones by the placenta like human placental lactogen, cortisol, prolactin, growth hormone, estrogen, and progesterone which cause insulin resistance. 2) This insulin resistance develops in mid-pregnancy and results in low fasting blood sugar but high post-prandial blood sugar as well as low renal threshold for glucose and increased glucose in the urine (glycosuria). 3) The insulin receptors cannot fully respond to insulin so glucose transporters become inactive, glucose cannot enter cells, and hyperglycemia occurs to supply nutrients to support the growth and demands of the fetus and mother.

1. CARBOHYDRATE
METABOLISM
DURING
PREGNANCY
At the end of the module, you should be able
to,
 Describe the changes occurring in
carbohydrate metabolism during
pregnancy ,
 Explain the causes and significance of these
metabolic changes.

2. Normal Carbohydrate
metabolism

3. Changes in Carbohydrate
metabolism in Pregnancy-
Reason?
 Metabolic changes are essential for the continuous supply of
glucose and amino acids for fetal growth as well as for
meeting the increased physiological demands of the woman
during pregnancy, labour and lactation.
 Food intake and appetite are increased, activity is decreased,
approximately 3.5kg of fat is deposited, energy reserves of
approximately 30000kcal are established and 900g of new
protein is synthesized by the mother, fetus and placenta.

4. Changes in Carbohydrate
metabolism in Pregnancy-
Mechanism
 Pregnancy is hyperlipidemic and glucosuric state
 After mid-pregnancy, resistance of insulin develops, due to
placental production of anti-insulin hormones like, Human
placental lactogen , Cortisol , prolactin , GH , estrogen and
progesterone
 The effects of these hormones cause,
a)Low FBS with high PPBS
b)Low renal threshold for glucose & increase in GFR leads to
glycosuria
c) Increased production of insulin and high fasting insulin that

5. Changes in Carbohydrate
metabolism in Pregnancy- Insulin
receptors
 The insulin receptors cannot full respond to insulin, so
glucose transporters become inactive.
 Glucose can not enter into the cells of the tissues
especially muscle tissues and cause hyperglycemia.
 Insulin resistance is induced by tumour necrosis factor α
and a new protein called resistin that produced by the
adipose tissues.

6. Changes in Carbohydrate
metabolism in Pregnancy-
Summary
Anti-insulin hormones like, Hpl
, Cortisol , prolactin , Gh ,
estrogen and progesterone
placenta
The insulin receptors cannot
full respond to insulin, so
glucose transporters
become inactive.