Even though the basis for hypoadiponectinemia and GDM is unclear, suggested mechanisms for the insulin sensitizing effect of adiponectin include (a) promotion of insulin signaling at the receptor/postreceptor level, (b) reduction of gluconeogenesis, (c) improved lipid oxidation, and (d) inhibition of TNF-α signaling in adipose tissue [55]. Here, TNF is linked to gestational diabetes.