Is it time to revisit the Pedersen hypothesis in the face of the obesity epidemic?

The Pedersen hypothesis was formulated more than 50 years ago. Jorgen Pedersen primarily cared for women with type 1 diabetes. He suggested that fetal overgrowth was related to increased transplacental transfer of glucose, stimulating the release of insulin by the fetal beta cell and subsequent macr...

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Bibliographic Details
Published in:American journal of obstetrics and gynecology 2011-06, Vol.204 (6), p.479-487
Main Authors: Catalano, Patrick M., MD, Hauguel-De Mouzon, Sylvie, PhD
Format: Article
Language:English
Subjects:
Biological and medical sciences
Diabetes, Gestational - metabolism
Female
fetal adiposity
Fetal Macrosomia - etiology
Fetus - metabolism
Gynecology. Andrology. Obstetrics
Homeostasis
Humans
Inflammation - metabolism
Lipid Metabolism
Medical sciences
Metabolic diseases
Obesity
Obesity - epidemiology
Obesity - metabolism
Obstetrics and Gynecology
Pregnancy
Pregnancy in Diabetics - metabolism
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Summary:The Pedersen hypothesis was formulated more than 50 years ago. Jorgen Pedersen primarily cared for women with type 1 diabetes. He suggested that fetal overgrowth was related to increased transplacental transfer of glucose, stimulating the release of insulin by the fetal beta cell and subsequent macrosomia. Optimal maternal glucose control decreased perinatal mortality and morbidity. However, over the ensuing decades, there have been increases in maternal obesity and subsequently gestational diabetes mellitus (GDM) and type 2 diabetes. The underlying pathophysiology of type 1 and GDM/type 2 diabetes are fundamentally different, type 1 diabetes being primarily a disorder of beta cell failure and type 2 diabetes/GDM including both insulin resistance and beta cell dysfunction. As such the metabolic milieu in which the developing fetus is exposed may be quite different in type 1 diabetes and obesity. In this review we examine the metabolic environment of obese diabetic women and lipid metabolism affecting fetal adiposity. The importance of understanding these issues relates to the increasing trends of obesity worldwide with perinatal programming of metabolic dysfunction in the offspring.
ISSN:0002-9378
1097-6868
DOI:10.1016/j.ajog.2010.11.039