Diabetes Mellitus in PregnancyMetabolic Changes in PregnancyLAIN, KRISTINE Y. MD*; CATALANO, PATRICK M. MD† Author Information *Departments of Obstetrics and Gynecology and Internal Medicine, University of Kentucky, Lexington, Kentucky †Department of Reproductive Biology, Case Western Reserve University at MetroHealth Medical Center, Cleveland, Ohio Supported by NIH/HD-22965 (P.M.C.). Correspondence: Kristine Y. Lain, MD, University of Kentucky, 800 Rose Street, Room C365, Lexington, KY 40536-0293. E-mail: [email protected] Clinical Obstetrics and Gynecology: December 2007 - Volume 50 - Issue 4 - p 938-948 doi: 10.1097/GRF.0b013e31815a5494 Buy Metrics Abstract Maternal metabolism changes substantially during pregnancy. Early gestation can be viewed as an anabolic state in the mother with an increase in maternal fat stores and small increases in insulin sensitivity. Hence, nutrients are stored in early pregnancy to meet the feto-placental and maternal demands of late gestation and lactation. In contrast, late pregnancy is better characterized as a catabolic state with decreased insulin sensitivity (increased insulin resistance). An increase in insulin resistance results in increases in maternal glucose and free fatty acid concentrations, allowing for greater substrate availability for fetal growth. © 2007 by Lippincott Williams & Wilkins.