Pathological mechanisms of gestational diabetes mellitus development

Abstract

gestational diabetes mellitus (GDM) is a metabolic disorder of pregnancy characterized by persistent hyperglycemia in women without a prior diabetes diagnosis. This condition primarily arises from im- paired glucose tolerance due to pancreatic β-cell dysfunction against a background of chronic insulin resistance. The primary risk factors for GDM development include overweight, obesity, advanced maternal age, and genetic predisposition to diabetes or other glucose metabolism disorders. GDM consequences impact not only maternal health increasing the risk of cardiovascular diseases and type 2 diabetes. But the infant, leading to macrosomia and potential delivery complications. In the long term, the child may also be prone to obesity, type 2 diabetes, and cardiovascular diseases. The global prevalence of gestational diabetes is approximately 16.5% of all pregnancies, and these rates continue to rise amid the obesity epidemic. Despite the availability of various therapeutic strategies, such as insulin therapy or lifestyle modifications, there is currently no universal or effective treatment prevention of GDM. One of the major challenges is the limited understanding of the molecular mechanisms underlying this disease. This review explores the current understanding of the pathophysiology of gestational diabetes mellitus and highlights critical gaps in the literature that warrant further investigation.