TNF and gestational diabetes: The prevalence of GDM is high and goes up to 30% in some populations.[2] Resistance to insulin increases with gestational age.[2] Placental hormones such as lactogen, tumor necrosis factor alpha, growth hormones, progesterone, and cortisol are responsible for this insulin resistance.[3,4] Thus, the glucose supply increases in mothers to help fetal growth and development.[4] GDM occurs when the secretion of insulin is inadequate for the degree of resistance.[3]