Salamualaikum, some tiny homework I had to do for tomorrow’s presentations, so to dearest Professor, let me present you:
1. Why do pregnancy increases glucose intolerance?
2. Why do pregnancy increases the risk of ketoacidosis?
My ambition to be an Obstetrics & Gynaecologist, like seriously inshAllah I hope it will turn true. Despite the challenge of balancing my future family and the hectic commitment this specialization requires me too, I’m.. kind of up to it subhanAllah. 🙂 InshAllah we’ll see how!
Dearest Professor, let me explain please,
Why do pregnant moms have an increase in glucose intolerance?
1. When pregnant, there is an increas in sex steroids and other hormones, which are being metabolized, thus this increase insulin demand.
More specificaaly, in pregnancy, human placental lactogen which is similar to growth hormone and tumour necrosing factor- alpha, induce changes in the insulin receptor and in post receptor signaling. Changes in the beta-subunit of the insulin receptor, decreased the phosphorylation of tyrosine kinase on the insulin receptor, and alterations in insulin receptor substrate-1 (IRS-1) & the intracytoplasmic phosphatidylinositol 3- kinase (PI3K) appear to be involved in reducing glucose uptake in skeletal muscle tissue.
(Haha, sounds complicated, yes, but no actually 😉 )
2. Why pregnancies increases the risk of ketoacidosis?
Particular in 3rd Trimester, due to above reasons which causes increases in insulin resistance, this confers a susceptibility to ketoacidosis. One of the rare causes of this is severe vomitting.- also known as starvation ketoacidosis.
We have to note that there are other factos precipitating ketoacidosis in diabetic pregancies such as infection, non-compliance, insulin pump failure, Beta sympathetomimetic drugs, corticosteroids, and poor management.
other factors contributing are:
1. Insulin antagonistic state, accelerated starvation(2nd and 3rd trimester) effect of emesis and lowered buffering capacity secondary to increased minute alveolar ventilation.
Allahumma yasir wala tu’assir.