β-cell mass dynamics during pregnancy in the mouse. (a) β-cell mass is increased by both (b) β-cell replication and (c) β-cell hypertrophy during the first two-thirds of gestation. After parturition, maternal β-cell mass returns to non-pregnant levels by (d) β-cell apoptosis, which increases through the end of pregnancy and is still detected 4–6 days after birth. The graphs represent approximate changes in these processes before pregnancy (red, non-pregnant), over the course of pregnancy (light purple) and post-partum (green), and show what is believed to occur during human pregnancy based on rodent studies. Serum lactogenic hormone levels during pregnancy are increased from gestational day 10 to 20, pointing to their key role in the adaptation of the islet to pregnancy [9].