INS and gestational diabetes: Alterations associated with GDM result from a change in the amount of D-glucose available to the fetus due to alterations in the physiology of the placenta (e.g., increased D-glucose transplacental transport) or by hormone-induced dysfunction (e.g., altered insulin signalling), phenomena that could lead to abnormal growth of the fetus (macrosomia) and perinatal complications [16, 55, 56].