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The insulin/IGF system regulates fetal and placental growth and development. In a pregnancy complicated by maternal diabetes, placentas are hypervascularized and fetal insulin levels are elevated. In the fetal circulation, insulin can act on the placenta through insulin receptors present on the fetoplacental endothelial cells.

the journal of clinical endocrinology and metabolism/journal of clinical endocrinology and metabolism

Hyperinsulinemia Stimulates Angiogenesis of Human Fetoplacental Endothelial Cells: A Possible Role of Insulin in Placental Hypervascularization in Diabetes Mellitus