The three main mechanisms of action are: reduction of hepatic gluconeogenesis, reduction of glucose absorption by the gastrointestinal tract, and improvement in the use of peripheral glucose by increasing cellular sensitivity to insulin.12 It was initially developed for use in type-2 diabetes mellitus (DM2) and, because it crosses the placental barrier, its administration in cases of GDM was delayed. The gene discussed is INS; the disease is gestational diabetes.