Gestational diabetes is most commonly associated with temporary disturbances in glucose metabolism during pregnancy. However, growing evidence shows that its consequences may extend far beyond pregnancy itself—affecting a child’s health even before birth and increasing the risk of obesity, insulin resistance, and diabetes later in life.
A recent publication by researchers from Wroclaw Medical University and Wrocław University of Science and Technology, published in Frontiers in Endocrinology, examines the role of adipokines—hormones secreted by adipose tissue—in shaping the metabolic environment of both the mother and the developing fetus. The researchers investigated how gestational diabetes influences leptin, adiponectin, and markers of leptin resistance, and whether these factors could serve as early indicators of future metabolic disorders.
Until recently, many metabolic diseases were viewed primarily as a consequence of adult lifestyle choices. Today, scientists increasingly recognize the importance of the prenatal period.
Fetal life is a crucial stage during which a child’s metabolism is programmed for the decades ahead. Even at this early stage of development, elevated maternal glucose levels and altered metabolic parameters can affect the metabolic balance of the developing organism, - explains Dr. Jolanta Lis-Kuberka from the Department of Biochemistry and Immunochemistry at Wroclaw Medical University.
Studies show that fetal exposure to an unfavorable metabolic environment may promote increased fat accumulation and changes in insulin sensitivity from a very early stage of life.
At the center of the researchers’ interest were adipokines—molecules produced by adipose tissue that regulate the body’s energy metabolism.
Particular attention was given to leptin and adiponectin. Leptin plays an important role in regulating appetite and energy metabolism, while adiponectin enhances insulin sensitivity in tissues and exerts anti-inflammatory effects.
Leptin and adiponectin serve as specific biomarkers of maternal and fetal metabolism. Persistently elevated leptin levels accompanied by reduced adiponectin concentrations characterize a metabolic environment that promotes obesity and disturbances in glucose homeostasis in both pregnant women and their children,- emphasizes Dr. Lis-Kuberka.
The authors also highlight the significance of indicators such as the Free Leptin Index (FLI) and the Leptin-to-Adiponectin Ratio (LAR), which may reflect the severity of metabolic disturbances associated with gestational diabetes.
Scientists are paying increasing attention to the phenomenon known as metabolic programming. This concept assumes that conditions present in the mother’s body during pregnancy can influence the child’s metabolism throughout life.
Metabolic programming is based on the premise that the earliest experiences of the organism—from fetal development through the perinatal period and early childhood—have a lasting impact on metabolic regulation and responsiveness to environmental factors,- explains Dr. Lis-Kuberka.
Particular importance is now attributed to the concept of the “first 1,000 days of life,” covering the period from conception to approximately a child’s second birthday. It is during this critical window that biological mechanisms influencing the future risk of diabetes, obesity, and other non-communicable diseases may be established.
One of the most promising areas of research is the use of adipokines as biomarkers to identify children at increased risk of metabolic disorders.
In the future, markers such as leptin, adiponectin, and indicators of leptin resistance may enable the early identification of children who are particularly vulnerable to developing diabetes, obesity, or insulin resistance,- says the researcher. - This opens the possibility of highly personalized preventive strategies long before the first clinical symptoms appear.
The authors emphasize that proper diagnosis and monitoring of gestational diabetes are important not only for the course of pregnancy itself but also for long-term health outcomes.
Appropriate diagnosis and careful monitoring of gestational diabetes are now considered not only the foundation of perinatal safety but also a key element of health prevention strategies that benefit future generations,- notes Dr. Lis-Kuberka.
It is also becoming increasingly clear that effective prevention requires collaboration among specialists from various disciplines, including diabetologists, gynecologists, dietitians, physiotherapists, psychologists, and public health experts.
Care for women with gestational diabetes represents the first crucial step in preventing lifestyle-related diseases at the population level. As a result, perinatal care is evolving from a reactive model toward a proactive strategy aimed at preventing diabetes, obesity, and other metabolic disorders in future generations,- concludes the researcher.
The findings of the team led by scientists from Wroclaw Medical University demonstrate that the origins of many metabolic diseases may reach back to fetal life. Understanding the mechanisms of metabolic programming allows us to view disease prevention as a process that begins even before birth.
This article is based on:
Gestational diabetes mellitus–induced adipokine dysregulation and links to metabolic programming risks
https://www.frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2026.1776904/full
Authors: Jolanta Lis-Kuberka, Marta Berghausen-Mazur
Frontiers in Endocrinology, 2026
Frontiers in Endocrinology
Literature review
People
12-May-2026
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.