Cellular Mechanisms for Insulin Resistance in Normal Pregnancy and Gestational Diabetes

Infusion of TNF-α results in increased insulin resistance in rat and human skeletal muscle cells incubated in culture (21), although TNF-α neutralization over a period of 4 weeks had no effect on insulin sensitivity in obese type 2 diabetic subjects (22). The role of excess lipid turnover and cytokine production from adipose tissue, especially in obese patients, could potentially be very important in the overall insulin resistance and excess substrate supply that drives maternal-fetal energy transfer and increased neonatal adiposity.