- Abnormal carbohydrate metabolism during pregnancy, such as impaired glucose tolerance and gestational diabetes, affects 2-5% of pregnancies. - Women with gestational diabetes have an increased risk of preeclampsia and developing type 2 diabetes later in life. - Disorders of carbohydrate metabolism during pregnancy are associated with increased maternal and fetal/neonatal morbidity.

1. Carbohydrate Metabolism in
Pregnancy
Dr Venkatesh Karthikeyan
Email : 4852012@gmail.com

2. Glucose
• Glucose is the preferred source of energy for
most of the body tissues.
• Brain cells derive the energy mainly from
glucose.
• Normal fasting plasma glucose level is 70 to
110 mg/dl.

3. Why Carbohydrate metabolism seminar in
OG Posting?

4. • Abnormal carbohydrate metabolism
during pregnancy, such as Impaired
glucose tolerance and Gestational
Diabetes is a relatively frequent disease
affecting ∼2–5% of all pregnancies.
Source : American Diabetes Association

5. • It has been shown that women with GDM have
an increased incidence of preeclampsia
Source : American Diabetes Association

6. • Furthermore, these patients are more prone to
development of type 2 diabetes, a known
condition that leads to an increased risk for
cardiovascular disease , later in life.
Source : American Diabetes Association

7. • In common with other maternal disorders
associated with macrovascular dysfunction,
abnormal carbohydrate metabolism is
associated with augmented maternal and
fetal-neonatal morbidity.
Source : American Diabetes Association

8. Glycolysis

9. Significance of the Glycolysis Pathway
• Takes place in all the cells of the body.
• Only source of energy in erythrocytes.
• In strenuous exercise, when muscle tissue lacks enough
oxygen, anaerobic glycolysis forms the major source of
energy for muscles.
• It is preliminary step before complete oxidation.
• Provides carbon skeletons for synthesis of non-essential
amino acids as well as glycerol part of fat.

10. Energitics

12. Significance of Gluconeogenesis
• Only liver can replenish blood glucose through gluconeogenesis.
• During starvation gluconeogenesis maintains the blood glucose level.
Energy Requirement:
• 2 pyruvate →2 oxaloacetate = 2 ATP
• 2 oxaloacetate → 2 phosphoenol
• pyruvate (2GTP) = 2 ATP
• 2 x 3-phosphoglycerate →2 x 1,3-bisphospho
• glycerate = 2 ATP
• Total = 6 ATP

13. Glycogenolysis

14. Formation of Glycogen

15. HMP PATHWAY

16. Significance of HMP Pathway
1. Required for reductive biosynthesis, such as
fatty acid, cholesterol and steroids
2. Free radical scavenging
3. RBC membrane integrity
4. Prevention of formation of met-hemoglobin
5. Detoxification
6. Preserving transparency of lens of eye
7. Bactericidal activity of macrophages
8. Production of ribose and deoxyribose for
DNA and RNA synthesis

17. Cori’s cycle
• Significance of the Cori's cycle: The lactate produced in the muscle is
efficiently reutilized by the body. But this is an energy-consuming process.
During exercise, lactate production is high, which is utilized by liver to
produce glucose. This process needs ATP in significant quantities, which is
provided by increased metabolism. This leads to increased oxygen
consumption. This is the explanation for the oxygen debt after vigorous
exercise.

18. Galactose Metabolism

19. Merci!(Thank you in French)