In the early and middle stages of pregnancy, as the gestational age increases, the fetus's demand for nutrients increases. The glucose obtained from the mother through the placenta is the main source of fetal energy. The plasma glucose level of pregnant women decreases with the progress of pregnancy, and the fasting blood glucose is reduced by about 10%.

There are the following reasons: 1. The fetus receives more glucose from the mother; 2. The renal plasma flow rate and glomerular filtration rate increase during pregnancy, but the reabsorption rate of the renal tubules does not increase correspondingly, resulting in an increase in the amount of sugar excreted in some pregnant women;3. Estrogen and progesterone increase the use of glucose by the mother.

Therefore, the ability of pregnant women to clear glucose on an empty stomach is stronger than that during non-pregnancy.The fasting blood glucose of pregnant women is lower than that of non-pregnant women. By the middle and late pregnancy, the increase of anti-insulin substances in pregnant women, such as placental lactogen, estrogen, progesterone, cortisol and placental insulinase, makes the sensitivity of pregnant women to insulin decrease with the increase of gestational age,

In order to maintain normal levels of glucose metabolism, insulin demand must increase accordingly.

For pregnant women with limited insulin secretion, this physiological change during pregnancy cannot compensate for the physiological changes, which may cause GDM in the original diabetic family.

Common Sense:

Monk fruit extract is derived from the pulp of the fruit and is used to sweeten foods and beverages without the calories of sugar. In addition, the extract appears to lower both blood sugar and blood lipids in experimental models of animal diabetes.The active sweet substances appear to be the mogrosides which are about 2- 300 times the as sweet as table sugar. The mogrosides also function as antioxidants, potentially limiting the oxidative damage caused by high levels of blood glucose.