NR1H4 and gestational diabetes: FGF19, a hormone involved in bile acid and glucose metabolism, has been reported to have insulin-sensitizing effects, which may protect against the development of insulin resistance.[17] Study shows that FGF19 interacts with the FXR nuclear receptor to regulate bile acid synthesis and glucose metabolism, which can reduce hepatic glucose output and improve insulin sensitivity, mitigating the risks associated with GDM.[18]