Central actions of insulin during pregnancy and lactation. (12th March 2021)

• Record Type: Journal Article
• Authors: Ladyman, Sharon R.; Brooks, Virginia L.
• Other Names: Andrews Zane guestEditor.; Grattan David guestEditor.
• Is Part Of: Journal of neuroendocrinology. Volume 33:Number 4(2021)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2021-03-12
• Subjects: insulin -- lactation -- pregnancy; Neuroendocrinology -- Periodicals; 616.4
• DOI: 10.1111/jne.12946
• Languages: English
• ISSNs: 0953-8194

Abstract

Abstract: Pregnancy and lactation are highly metabolically demanding states. Maternal glucose is a key fuel source for the growth and development of the fetus, as well as for the production of milk during lactation. Hence, the maternal body undergoes major adaptations in the systems regulating glucose homeostasis to cope with the increased demand for glucose. As part of these changes, insulin levels are elevated during pregnancy and lower in lactation. The increased insulin secretion during pregnancy plays a vital role in the periphery; however, the potential effects of increased insulin action in the brain have not been widely investigated. In this review, we consider the impact of pregnancy on brain access and brain levels of insulin. Moreover, we explore the hypothesis that pregnancy is associated with site‐specific central insulin resistance that is adaptive, allowing for the increases in peripheral insulin secretion without the consequences of increased central and peripheral insulin functions, such as to stimulate glucose uptake into maternal tissues or to inhibit food intake. Conversely, the loss of central insulin actions may impair other functions, such as insulin control of the autonomic nervous system. The potential role of low insulin in facilitating adaptive responses to lactation, such as hyperphagia and suppression of reproductive function, are also discussed. We end the review with a list of key research questions requiring resolution. Abstract : Maternal adaptation in glucose regulation leads to increased insulin levels in pregnancy and lower insulin levels during lactation. How these changes in insulin levels impact on central insulin actions in these reproductive states has yet to be thoroughly explored. Emerging evidence indicates site‐specific central insulin resistance develops during pregnancy, hypothesized to prevent excessive insulin action in the brain, while low insulin levels in lactation are potentially important in facilitating adaptive responses in the brain.