Which hormone primarily affects glucose metabolism during pregnancy, complicating diabetes management?

Human placental lactogen (HPL) is the hormone that primarily affects glucose metabolism during pregnancy and plays a significant role in managing energy needs for the growing fetus. Its secretion increases as the placenta develops, and it has several critical functions, including promoting maternal insulin resistance to ensure that glucose is available for the fetus. By shifting the mother’s metabolism to utilize fats for energy, HPL allows sufficient glucose to remain in the bloodstream for placental transfer to the developing fetus.

This insulin resistance can complicate diabetes management as it makes glucose control more challenging for pregnant individuals who have pre-existing diabetes or who develop gestational diabetes. The increase in HPL levels can lead to higher blood glucose levels, necessitating adjustments in the management of diabetes during pregnancy to maintain both maternal and fetal health.

Other hormones mentioned, though they are involved in various aspects of pregnancy, do not directly impact glucose metabolism in the same critical manner as HPL does. Estrogen and progesterone play roles in overall pregnancy maintenance and development of the uterus but do not directly alter glucose metabolism. Oxytocin is primarily involved in labor and milk ejection during breastfeeding and does not significantly influence glucose management during pregnancy.