Methods: Q-RT- PCREV presence confirmed as early as 8 weeks gestation.4335 initial targets narrowed to 58 targets involved in 257 pathways. 3 pathways selected for this analysis: the type 2 diabetes mellitus signaling pathway, the insulinreceptor signaling pathway, and the AMP-activated protein kinase (AMPK) signaling pathway.Validation: Internal validation per Brosseau et al.Tissue: Serum extracellular vesicles. Here, INSR is linked to diabetes mellitus.