SIRT1 and gestational diabetes: SIRT1 upregulates QKI5 to promote PPARγ expression and activate the PI3K/AKT pathway, thereby ameliorating GDM pathology [62]; Galacto-oligosaccharides significantly improve metabolic parameters in a GDM rat model by modulating the PPARs/PI3K/Akt pathway and gut microbiota [63].