INS and obesity due to melanocortin 4 receptor deficiency: However, the DALI (Vitamin D and lifestyle intervention for GDM prevention) study group reported that among pregnant women with obesity, healthy eating and physical activity alone were unlikely to prevent GDM development, nor was it a cost-effective early intervention to decrease fasting glucose and insulin sensitivity (Simmons et al., 2017), emphasizing the need for new preventive approaches.