INS and Insulin resistance: Pregnancy is associated with an adaptive response to hormonal and metabolic changes primarily driven by the feto-placental unit.5 As a master regulator to coordinate systemic glucose homeostasis, insulin signaling adapts to maintain normoglycemia in early pregnancy and ensures a sufficient supply of nutrients to the fetus, such as increased insulin secretion from pancreatic β-cells and blunted response to insulin-stimulated glucose uptake in peripheral tissues, especially skeletal muscle.5 Insulin resistance is an established trigger of hyperglycemia during pregnancy.