APOA1 and gestational diabetes: While it is suggested that insulin therapy produces an improvement in lipid levels in women with GDM [37,38,93], other studies have also suggested that insulin therapy generates a pro-atherogenic profile in overweight and obese women with GDM, which is associated with increased levels of TC and TG, low levels of HDL and apo AI (the main protein of HDL), increased levels of the inflammatory marker interleukin-6 [12,14,85,99], impaired blood flow in the forearm skin [14,104] and greater arterial stiffness after delivery [105].