CYP3A4 and gestational diabetes: They also noticed that lidocaine clearance was lower in pregnant women with gestational diabetes, suggesting that gestational diabetes reduced the activity of CYP3A4 (and possibly CYP1A2) which is responsible for the metabolism of this drug although the combinatorial effect of pregnancy and gestational diabetes (i.e., diabetes with a different origin than T2DM), cannot be excluded [115].