XDH and gestational diabetes: As noted in Law et al. review of the pathophysiologyand pathogenesis of GDM, the xanthine oxidase-driven process of oxidizinghypoxanthine into xanthine and then uric acid generates superoxideanions which are associated with increased inflammation and impairedinsulin secretion.26 Therefore, the alteredpurine degradation pathway observed in this study may be due to theincrease in nucleotide synthesis seen with glucose dysregulation,thus resulting in an increase in ROS, which contributes to insulinresistance.