Kopp Wolfgang
Diagnostikzentrum Graz, Mariatrosterstrasse 41, 8043 Graz, Austria.
Med Hypotheses. 2005;64(1):101-3. doi: 10.1016/j.mehy.2004.06.004.
A transient physiologic insulin resistance and hyperinsulinemia are characteristic of normal pregnancy. This insulin action has evolved during a period of human evolution that was characterized by a very low-carbohydrate nutrition. The development of gestational diabetes mellitus (GDM) is proposed to result from a collision of this evolutionary inheritance with our "modern" nutrition: The "Western" high-insulinogenic nutrition increases the postprandial demand for insulin significantly during the insulin resistant state of late pregnancy. In women with beta-cells that are not capable of maintaining the high insulin production, GDM develops. A restriction of high-insulinogenic carbohydrate may help to prevent the development of GDM.
短暂的生理性胰岛素抵抗和高胰岛素血症是正常妊娠的特征。这种胰岛素作用是在人类进化过程中形成的,当时的特点是碳水化合物营养非常低。妊娠期糖尿病(GDM)的发生被认为是这种进化遗传与我们的“现代”营养发生冲突的结果:“西方”高胰岛素生成性营养在妊娠晚期胰岛素抵抗状态下显著增加了餐后对胰岛素的需求。对于那些β细胞无法维持高胰岛素分泌的女性,就会发展为妊娠期糖尿病。限制高胰岛素生成性碳水化合物可能有助于预防妊娠期糖尿病的发生。