insulin resistance in pregnancy is due to which hormone?
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Insulin resistance in pregnancy is caused by multiple placental hormones acting together, not a single hormone. The key culprits are:
Hormones Responsible for Insulin Resistance in Pregnancy
| Hormone | Source | Role |
|---|---|---|
| Human Placental Lactogen (hPL) — also called Human Chorionic Somatomammotropin (hCS) | Placenta | Primary driver; has GH-like and contra-insulin effects |
| Human Placental Growth Hormone | Placenta | Causes severe insulin resistance (GH variant) |
| Progesterone | Placenta/corpus luteum | Diabetogenic effect |
| Corticotropin-releasing hormone (CRH) | Placenta | Contributes to insulin resistance |
| Placental steroids | Placenta | Counter-insulin effects |
Key Points
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Human Placental Lactogen (hPL/hCS) is considered the most important single contributor. Morgan & Mikhail's Clinical Anesthesiology states it is "probably responsible for the relative insulin resistance associated with pregnancy."
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In a normal pregnancy, insulin sensitivity is reduced by approximately 60%, requiring compensatory pancreatic beta cell hyperplasia and increased insulin secretion.
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This state is intentionally diabetogenic — it diverts glucose to the fetus by making maternal tissues relatively resistant to insulin.
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When the pancreas cannot compensate adequately, gestational diabetes mellitus (GDM) develops.
If a single answer is required for an exam: Human Placental Lactogen (hPL) is the primary hormone responsible for insulin resistance in pregnancy.
Sources: Goldman-Cecil Medicine; Morgan & Mikhail's Clinical Anesthesiology, 7e; Harrison's Principles of Internal Medicine 22E; Creasy & Resnik's Maternal-Fetal Medicine
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