Role of high-insulinogenic nutrition in the etiology of gestational diabetes mellitus.

A transient physiologic insulin resistance and hyperinsulinemia are characteristic of normal pregnancy. This insulin action has evolved during a period of human evolution that was characterized by a very low-carbohydrate nutrition. The development of gestational diabetes mellitus (GDM) is proposed to result from a collision of this evolutionary inheritance with our "modern" nutrition: The "Western" high-insulinogenic nutrition increases the postprandial demand for insulin significantly during the insulin resistant state of late pregnancy. In women with beta-cells that are not capable of maintaining the high insulin production, GDM develops. A restriction of high-insulinogenic carbohydrate may help to prevent the development of GDM.