As gestational diabetes and preeclampsia share risk factors, including poor glycemic control and prepregnancy obesity, appropriate management of these risk factors, including prepregnancy weight loss, nutritional therapy, moderate exercise, glucose monitoring, and insulin therapy (if target glucose levels are not achieved with diet alone) are recommended by the American Diabetes Association (ADA) and ACOG.41, 42 Insulin is the preferred medication for treating hyperglycemia as it does not cross the placenta to a measurable extent. This evidence concerns the gene INS and obesity due to melanocortin 4 receptor deficiency.