The role of iron overload in the development of gestational diabetes mellitus and other metabolic disorders during pregnancy

The role of iron in the development of disorders of carbohydrate metabolism has been known for a long time. The first observations were based on the increased risk of diabetes mellitus in patients suffering from hereditary disorders of iron metabolism with increased iron deposition in the liver and pancreas in haemochromatosis. Subsequently, disorders of carbohydrate metabolism during pregnancy (gestational diabetes mellitus) were associated mainly with increased insulin resistance, impaired insulin secretion in genetically predisposed individuals, with obesity and metabolic syndrome in women before gestation. However, there is increasing evidence to support the hypothesis of the role of iron overload associated with metabolic syndrome, metabolically associated fatty liver disease, induction and progression of disorders of carbohydrate metabolism. The article presents current data on the association between disorders of iron metabolism and the risk of developing gestational diabetes mellitus. It discusses the mechanisms how ferrokinetics influence glucose intolerance and considers the role of iron supplements in the development of gestational diabetes mellitus. The review refers to the current clinical recommendations and algorithms of medical care adopted in the Russian Federation and abroad, as well as to the data of some of the most recent studies on the issue.

Conclusion: The process of iron metabolism in pregnant women is complex and involves various regulatory mechanisms. It is associated with metabolic risks that are present before pregnancy or that arise during pregnancy. Iron overload may increase the risk of developing gestational diabetes mellitus, and this should be considered when developing a personalized algorithm for monitoring pregnant women.