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. 2025 Sep 7;26(17):8719. doi: 10.3390/ijms26178719

Figure 1.

Figure 1

Molecular Mechanisms in GDM. (Figure created in BioRender. Assani, M. (2025) https://BioRender.com/0xnbu0m). Pregnancy-induced insulin resistance is driven by placental hormones (human placental lactogen (hPL), placental growth hormone, estrogen, progesterone, cortisol) and inflammatory cytokines (tumor necrosis factor α (TNF α), interleukin 6 (IL-6), interleukin 1β (IL-1β)) [10,20]. Inadequate β-cell adaptation due to mitochondrial dysfunction, and impaired incretin signaling leads to hyperglycemia. Dysregulated adipokines (↓ adiponectin, ↑ leptin, resistin, visfatin), oxidative stress, and epigenetic modifications (deoxyribonucleic acid (DNA) methylation, non-coding ribonucleic acids (RNAs)) further exacerbate disease and contribute to adverse maternal and fetal outcomes [10,21].