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Diagnosis of gestational diabetes mellitus

Placental growth hormone (PGH) PGH is the product of the GH-V gene specifically expressed in the syncytiotrophoblast layer of the human placenta. PGH (20-kDa HGH-V) differs from pituitary growth hormone by 13 amino acids. It has high somatogenic and low lactogenic activities PGH is produced by the placenta and found predominantly in the maternal circulation. It progressively replaces pituitary growth hormone (hGH) in the human maternal circulation from mid-gestation onwards, peaking towards term (Chellakooty et al., 2004). PGH appears to be an important potential regulator of maternal insulin resistance in human pregnancy and may influence fetal growth both by modifying substrate availability and through paracrine actions in the placental bed (Mmonstrated a unique mechanism of insulin resistance in non-pregnant transgenic mice and suggested that human placental growth hormone (hPGH) may contribute to the insulin resistance of normal pregnancy secondary to its effect on p85 expression and its interference with PI 3-kinase activity in skeletal muscle. Nevertheless, in a recent experimental study by it was demonstrated that rats treated with HGH enhanced insulin sensitivity and suggested that HGH have an antidiabetic action. It seems that there is a controversy about the involvement of HGH with insulin resistance and GDM. In conclusion, considering the previously discussed hormones, HPL is considered as the main diabetogenic hormone synthesized and released from the feto-placental unit. But during pregnancy, there is another maternal hormone which is involved in insulin resistance which is prolactin.