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Pre-gestational diabetes can be classified as Type 1 or Type 2 depending on the physiological mechanism. Type 1 diabetes mellitus is an autoimmune disorder leading to destruction of insulin-producing cell in the pancreas; type 2 diabetes mellitus is associated with obesity and results from a combination of insulin resistance and insufficient insulin production.
Cardiovascular disease. Improving your diet and exercise habits can also improve your insulin sensitivity. Also, some causes of insulin resistance, like pregnancy, are temporary.
Hyperproinsulinemia is a disease where insulin is not sufficiently processed before secretion [1] and immature forms of insulin make up the majority of circulating insulin immunoreactivity in both fasting and glucose-stimulated conditions (insulin immunoreactivity refers to all molecules detectable by an insulin antibody, i.e. insulin, proinsulin, and proinsulin-like material).
More insulin is needed to overcome this resistance; about 1.5–2.5 times more insulin is produced than in a normal pregnancy. [27] Insulin resistance is a normal phenomenon emerging in the second trimester of pregnancy, which in cases of GDM progresses thereafter to levels seen in a non-pregnant woman with type 2 diabetes.
The leading cause of hyperglycemia in type 2 diabetes is the failure of insulin to suppress glucose production by glycolysis and gluconeogenesis due to insulin resistance. [39] Insulin normally inhibits glycogenolysis, but fails to do so in a condition of insulin resistance, resulting in increased glucose production. [ 40 ]
Hyperinsulinemia is a condition in which there are excess levels of insulin circulating in the blood relative to the level of glucose. While it is often mistaken for diabetes or hyperglycaemia, hyperinsulinemia can result from a variety of metabolic diseases and conditions, as well as non-nutritive sugars in the diet.
Pre-existing disease in pregnancy, or an acquired disease: A disease and condition not necessarily directly caused by the pregnancy. Diabetes mellitus in pregnancy; Lupus in pregnancy; Thyroid disease in pregnancy; Risks arising from previous pregnancies: Complications experienced during a previous pregnancy are more likely to recur. [64] [65]
Grown or made inside the body. Insulin made by a person's own pancreas is endogenous insulin. Insulin that is supplied from outside the body (i.e., injected or otherwise supplied) is exogenous. End-stage renal disease (ESRD) The final phase of many kidney diseases; treated by dialysis or kidney transplantation. See also: Dialysis; nephropathy ...