Sex hormones play a role in metabolic health, as demonstrated by gestational diabetes and differences in fat/muscle mass between boys and girls during puberty.

“and we know for sure that sex hormones have to play a role somewhere in there as well because there are women who develop gestational diabetes and their insulin their diets they don't change the differences they got pregnant right and that's a difference in sex hormones and some how that impacts and I actually don't know how this works but somehow it does impact the response of I'm not sure they're hyperinsulinemic either I think there must be something completely different about that entire thing but it's not as common so I don't I don't think about it as much or girls and boys at puberty for example the difference of girls and boys is testosterone versus estrogen for the most part it's not an insulin difference yet girls we go through puberty have way more fat than boys you get more muscle so we know that there are other hormones that clearly impact so it's not just about insulin but it's about cortisol it's about sex hormones”