These researchers demonstrated that the inositol-requiring enzyme-1 (IRE-1) arm of the ER stress pathway is increased in adipose tissue from obese pregnant women as well as women with gestational diabetes mellitus, as evidenced by the increased expression of the ER stress proteins, GRP78, IRE1, and/or transcription factor XBP-1 [37,38]. Here, ERN1 is linked to gestational diabetes.