Fetal undernutrition, placental insufficiency, and pancreatic β-cell development programming in utero

Ramkumar Mohan, Daniel Baumann, Emilyn Uy Alejandro

Research output: Contribution to journalReview articlepeer-review

26 Scopus citations


The prevalence of obesity and type 2 (T2D) diabetes is a major health concern in the United States and around the world. T2D is a complex disease characterized by pancreatic β-cell failure in association with obesity and insulin resistance in peripheral tissues. Although several genes associated with T2D have been identified, it is speculated that genetic variants account for only <10% of the risk for this disease. A strong body of data from both human epidemiological and animal studies shows that fetal nutrient factors in utero confer significant susceptibility to T2D. Numerous studies done in animals have shown that suboptimal maternal environment or placental insufficiency causes intrauterine growth restriction (IUGR) in the fetus, a critical factor known to predispose offspring to obesity and T2D, in part by causing permanent consequences in total functional β-cell mass. This review will focus on the potential contribution of the placenta in fetal programming of obesity and TD and its likely impact on pancreatic β-cell development and growth.

Original languageEnglish (US)
Pages (from-to)R867-R878
JournalAmerican Journal of Physiology - Regulatory Integrative and Comparative Physiology
Issue number5
StatePublished - Nov 2018

Bibliographical note

Funding Information:
This work was supported by the National Institute of Diabetes and Digestive and Kidney Diseases Grants K01-DK-103823 and R03-DK-114465 (to E. U. Alejandro).

Publisher Copyright:
© 2018 American Physiological Society. All rights reserved.

Copyright 2019 Elsevier B.V., All rights reserved.


  • Diabetes
  • Fetal programming
  • IUGR
  • Insulin secretion
  • Islet


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