TNF and Insulin resistance: However, the pathophysiological process of GDM also involves the participation of pro-inflammatory cytokines (IL-1β, IL-6, and TNF-α, among others) and oxidative stress (increase in RONS and AGEs, and decrease in antioxidant agents, among others) which, when associated, favor the exacerbation of insulin resistance, associated with hyperglycemia [8,13].