Gestational diabetes mellitus (GDM) is defined as glucose intolerance first diagnosed during pregnancy. This condition shares same array of underlying abnormalities as occurs in diabetes outside of pregnancy, for example, genetic and environmental causes. However, the role of a sedentary lifestyle and/or excess energy intake is more prominent in GDM. Physically active women are less likely to develop GDM and other pregnancy-related diseases. Weight gain in pregnancy causes increased release of adipokines from adipose tissue; many adipokines increase oxidative stress and insulin resistance. Increased intramyocellular lipids also increase cellular oxidative stress with subsequent generation of reactive oxygen species. A well-planned program of exercise is an important component of a healthy lifestyle and, in spite of old myths, is also recommended during pregnancy. This paper briefly reviews the role of adipokines in gestational diabetes and attempts to shed some light on the mechanisms by which exercise can be beneficial as an adjuvant therapy in GDM. In this regard, we discuss the mechanisms by which exercise increases insulin sensitivity, changes adipokine profile levels, and boosts antioxidant mechanisms. 1. Introduction Gestational diabetes mellitus (GDM) is the most prevalent metabolic disorder during pregnancy and is defined as glucose intolerance of variable severity that is first diagnosed during pregnancy and usually resolves not long after delivery [1, 2]. This definition includes any degree of glucose intolerance from just impaired to frankly diabetic [3]. Resolution of the condition is also important when differentiating between previously undiagnosed type 2 diabetes and GDM [4]. Insulin resistance, due to a series of hormonal changes, contributes to decreased blood glucose uptake by muscles [5]. This phenomenon seems to be important from an evolutionary point of view, as it ensures adequate glucose supply for fetal growth and development. In the third trimester a healthy pregnant woman has to increase her insulin secretion by 2–4 times to maintain glucose levels within normal limits. Pregnant women who develop GDM are unable to augment insulin production to compensate for their increased resistance to insulin [6]. There are several modifiable and unmodifiable risk factors for developing GDM. Obesity is a modifiable risk factor that is strongly associated with the development of gestational diabetes. In a survey of 97000 singleton births, obese women had a 3-fold increased risk of developing GDM than nonobese women [7]. Not only obese (body
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