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Insulin resistance\nis normally compensated for by an adaptive increase in pancreatic \u03b2-cell mass together with enhanced\nglucose-stimulated insulin release. Placentally-derived hormones and growth factors are central\nto the altered pancreatic morphology and function. A failure of \u03b2-cells to undergo adaptive change after\nthe first trimester has been linked with gestational diabetes. In the pregnant mouse, an increase in \u03b2-cell\nreplication contributes to a 2-3-fold increase in mass peaking in late gestation, depending on the proliferation\nof existing \u03b2-cells, the differentiation of resident progenitor \u03b2-cells, or islet cell transdifferentiation.\nUsing mouse models and human studies placenta- and islet of Langerhans-derived molecules\nhave been identified that are likely to contribute to the metabolic adaptations to pregnancy and\nwhose physiology is altered in the obese, glucose-intolerant mother. Maternal obesity during pregnancy\ncan create a pro-inflammatory environment that can disrupt the response of the \u03b2-cells to the endocrine\nsignals of pregnancy and limit the adaptive changes in \u03b2-cell mass and function, resulting in an increased\nrisk of gestational diabetes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2174\/1570161118666200320111209","type":"journal-article","created":{"date-parts":[[2020,3,20]],"date-time":"2020-03-20T09:38:48Z","timestamp":1584697128000},"page":"141-153","update-policy":"https:\/\/doi.org\/10.2174\/bsp_crossmark_policy","source":"Crossref","is-referenced-by-count":36,"title":["Metabolic Adaptations to Pregnancy in Healthy and Gestational Diabetic Pregnancies: The Pancreas - Placenta Axis"],"prefix":"10.2174","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2698-7224","authenticated-orcid":true,"given":"Sandra K.","family":"Szlapinski","sequence":"first","affiliation":[{"name":"Lawson Health Research Institute, St. Joseph\u2019s Health Care, 268 Grosvenor Street, London, Ontario N6A 4V2, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2490-5678","authenticated-orcid":true,"given":"David J.","family":"Hill","sequence":"additional","affiliation":[{"name":"Lawson Health Research Institute, St. Joseph\u2019s Health Care, 268 Grosvenor Street, London, Ontario N6A 4V2, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"965","reference":[{"key":"ref=1","doi-asserted-by":"publisher","first-page":"249","DOI":"10.2337\/diab.44.3.249","volume":"44","author":"Finegood D.T.","year":"1995","unstructured":"Finegood D.T.; Scaglia L.; Bonner-Weir S.; Dynamics of beta-cell mass in the growing rat pancreas. 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