Gutaj Paweł, Sawicka-Gutaj Nadia, Brazert Maciej, Wender-Ozegowska Ewa
Ginekol Pol. 2015 Mar;86(3):219-23. doi: 10.17772/gp/2065.
Insulin resistance (IR) is defined clinically as the inability of a known quantity of exogenous or endogenous insulin to increase glucose uptake and utilization. In recent years the increasing role of IR in the pathogenesis of type 1 diabetes mellitus (T1DM) related complications has been taken into account. The aim of this article is to discuss the possible role of IR in pregnancy complicated by T1DM. At the moment, there is no doubt that IR is not only frequently observed in T1DM patients, but also is a separate risk factor of several complications in nonpregnant patients. The role of IR in pregnancy complicated by T1DM has not been widely studied yet. However, data from the studies on different populations showed that IR may predispose to such conditions as miscarriage, preeclampsia and macrosomia. Interestingly all of these are more frequently diagnosed in women with T1DM in comparison to healthy subjects. The literature on the role of IR in human pregnancy is relatively rich. However despite its significance in pathophysiology of T1DM and its complications in general population, there is a lack of understanding of how it affects maternal and fetal health in pregnancy complicated by this disease. Nonetheless, based on the available literature, IR may be proposed as an additional factor modifying pregnancy outcome in woman with T1DM. Therefore, measures that might reduce IR such as good glycemic control and control of weight gain should be recommended for every woman with T1DM, optimally when planning but also throughout the pregnancy
胰岛素抵抗（IR）在临床上被定义为已知量的外源性或内源性胰岛素无法增加葡萄糖摄取和利用的情况。近年来，IR在1型糖尿病（T1DM）相关并发症发病机制中的作用日益受到关注。本文旨在探讨IR在合并T1DM的妊娠中的可能作用。目前，毫无疑问，IR不仅在T1DM患者中经常出现，而且是未怀孕患者发生几种并发症的独立危险因素。IR在合并T1DM的妊娠中的作用尚未得到广泛研究。然而，来自不同人群研究的数据表明，IR可能易导致流产、先兆子痫和巨大儿等情况。有趣的是，与健康受试者相比，所有这些情况在T1DM女性中更常被诊断出来。关于IR在人类妊娠中作用的文献相对丰富。然而，尽管其在T1DM的病理生理学及其在一般人群中的并发症中具有重要意义，但对于它如何影响合并该疾病的妊娠中的母婴健康仍缺乏了解。尽管如此，根据现有文献，IR可能被认为是影响T1DM女性妊娠结局的一个额外因素。因此，对于每一位T1DM女性，都应建议采取可能降低IR的措施，如良好的血糖控制和控制体重增加，最好在计划妊娠时就开始，并且在整个孕期都要进行。
