Genetic and epigenetic alterations associated with gestational diabetes mellitus and adverse neonatal outcomes

Figure 1 Risk factors involved in increased incidence of gestational diabetes mellitus. GDM: Gestational diabetes mellitus; PCOS: Polycystic ovary syndrome.

Figure 2 gestational diabetes mellitus linked with adverse maternal and newborn complications (i. e. type 2 diabetes mellitus, pre-eclampsia, hyperglycemia, caesarean delivery, recurrent gestational diabetes mellitus, miscarriage, type 1 diabetes mellitus, macrosmia, metabolic complications, obesity, neonatal hypoglycemia, shoulder dystocia, cardio-vascular diseases). T1DM: Type 1 diabetes mellitus; T2DM: Type 2 diabetes mellitus; GDM: Gestational diabetes mellitus.

Figure 3 Summarized role of various molecules participate in inflammatory and oxidative stress pathway in the pathophysiology of gestational diabetes mellitus. IL: Interleukin; TNF-α: Tumor necrosis factor-α; IRS: Insulin receptor substrates; mTOR: Mammalian target of rapamycin; TLRs: Toll-like receptor; RONS: Reactive oxygen and nitrogen species; ROS: Reactive oxygen species; AGE: Advanced glycation end products; PBMC: Peripheral blood mononuclear cells; NADPH: Nicotinamide adenine dinucleotide phosphate; NADH: Nicotinamide adenine dinucleotide; NADP+: Nicotinamide adenine dinucleotide phosphate oxidized; NAD+: Nicotinamide adenine dinucleotide oxidized; GPx: Glutathione peroxidase.

Figure 4 Genetic and epigenetic alterations are associated with environmental interaction involved in the pathophysiology of gestational diabetes mellitus. miRNAs: MicroRNAs; TCF7 L2: Transcription factor 7 like 2; KCNQ1: Potassium voltage-gated channel subfamily q member 1; MTNR1B: Melatonin receptor 1b gene; GCK: Glucokinase; IGF2BP2: Insulin-like growth factor 2 messenger RNA-binding protein 2; IRS1: Insulin receptor substrate-1; ADIPOQ: Adiponectin; IL-10: interleukin-10.