www.thelancet.com Published online June 201 2024 https234doi.org510.10166S0140-6736724800827-4 1

Apuntes

www.thelancet.com Published online June 20, 2024 https://doi.org/10.1016/S0140-6736(24)00827-4 1 Series Gestational Diabetes 1 Pathophysiology from preconception, during pregnancy, and beyond Marie-France Hivert, Helena Backman, Katrien Benhalima, Patrick Catalano, Gernot Desoye, Jincy Immanuel, Christopher J D McKinlay, Claire L Meek, Christopher J Nolan, Uma Ram, Arianne Sweeting, David Simmons*, Alicia Jawerbaum* Gestational diabetes is the most common medical complication in pregnancy. Historically, gestational diabetes was considered a pregnancy complication involving treatment of rising glycaemia late in the second trimester. However, recent evidence challenges this view. Pre-pregnancy and pregnancy-specific factors influence gestational glycaemia, with open questions regarding roles of non-glycaemic factors in the aetiology and consequences of gestational diabetes. Varying patterns of insulin secretion and resistance in early and late pregnancy underlie a heterogeneity of gestational diabetes in the timing and pathophysiological subtypes with clinical implications: early gestational diabetes and insulin resistant gestational diabetes subtypes are associated with a high...