Gestational diabetes mellitus (GDM) is the most common metabolic disorder of pregnancy. The underlying mechanism of GDM is impaired insulin sensitivity, driven by the dysfunction of insulin signaling pathways (IRS/PI3K/Akt) and the activation of inflammatory cascades (JNK, SOCS). Pregnancy hormones (placental lactogen, estrogens, progesterone) and adipokine imbalance (leptin, adiponectin, resistin) exacerbate these metabolic disturbances. This contributes to impaired lipolysis, elevated free fatty acid levels, and the development of microangiopathy. A bidirectional relationship exists between pregnancy and biological clocks. Sleep and circadian rhythm disruptions alter the secretion of melatonin and serotonin, directly impacting metabolic homeostasis and insulin production. This represents a significant risk factor for developing GDM, particularly in women with a history of endocrine disorders. Correcting circadian rhythm disruptions, in conjunction with metabolic control, may become a key element in the prevention and management of GDM.

Inna Korda, MD, PhD, graduated from the Ternopil State Medical Institute (Ukraine) in 1993 with a degree in General Medicine. She earned her PhD in Medical Sciences in 2001, defending her dissertation on the preventive therapy of purulent-septic complications in high-risk puerperas following cesarean section. Her primary research interests encompass gestational diabetes, endocrine gynecology, recurrent pregnancy loss, and effective methods for diagnosing and treating infertility. In addition to authoring over 53 scientific publications, including two educational manuals, Dr. Korda has successfully supervised three master's theses in the field of Nursing.