INS and Insulin resistance: In the second trimester, the secretion of diabetogenic hormones (such as human placental lactogen, growth hormone, progesterone, cortisol, and prolactin) increases, leading to insulin resistance.[1,34] That is caused by diabetogenic hormones interfering with insulin receptor signaling, which results in a reduction in insulin sensitivity in the peripheral tissues, including skeletal muscle and adipocytes.[36,37] After delivery, placental hormones help with maternal insulin sensitivity, to return to prepregnancy levels within a few days.[34]