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The ability of EVs to transfer molecular cargo between cells imbues them with potential as therapeutic agents. During pregnancy, the placenta assumes a vital role in metabolic regulation, with multiple mechanisms of placenta-mediated EV cross-talk serving as central components in GDM pathophysiology. This review focuses on the role of the placenta in the pathophysiology of GDM and explores the possibilities and prospects of targeting the placenta to address insulin resistance and placental dysfunction in GDM. Additionally, we propose the use of EVs as a novel method for targeted therapeutics in treating the dysfunctional placenta. The primary aim of this review is to comprehend the current status of EV targeting approaches and assess the potential application of these strategies in placental therapeutics, thereby delivering molecular cargo and improving maternal and fetal outcomes in GDM. We propose that EVs have the potential to revolutionize GDM management, offering hope for enhanced maternal\u2013fetal health outcomes and more effective treatments.<\/jats:p>","DOI":"10.1042\/cs20220150","type":"journal-article","created":{"date-parts":[[2023,8,31]],"date-time":"2023-08-31T07:00:53Z","timestamp":1693465253000},"page":"1311-1332","update-policy":"https:\/\/doi.org\/10.1042\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Extracellular vesicle-mediated targeting strategies for long-term health benefits in gestational diabetes"],"prefix":"10.1042","volume":"137","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6733-6164","authenticated-orcid":false,"given":"Soumyalekshmi","family":"Nair","sequence":"first","affiliation":[{"name":"1Translational Extracellular Vesicle in Obstetrics and Gynae-Oncology Group, UQ Centre for Clinical Research, Royal Brisbane and Women's Hospital, Faculty of Medicine, The University of Queensland, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valeska","family":"Ormazabal","sequence":"additional","affiliation":[{"name":"2Department of Pharmacology, Faculty of Biological Sciences, University of Concepcion, Concepci\u00f3n, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Flavio","family":"Carrion","sequence":"additional","affiliation":[{"name":"3Departamento de Investigaci\u00f3n, Postgrado y Educaci\u00f3n Continua (DIPEC), Facultad de Ciencias de la Salud, Universidad del Alba, Santiago, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aase","family":"Handberg","sequence":"additional","affiliation":[{"name":"4Department of Clinical Biochemistry, Aalborg University Hospital, Aalborg, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H\u00a0David","family":"McIntyre","sequence":"additional","affiliation":[{"name":"5Mater Research, Faculty of Medicine, University of Queensland, Mater Health, South Brisbane, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4474-0046","authenticated-orcid":false,"given":"Carlos","family":"Salomon","sequence":"additional","affiliation":[{"name":"1Translational Extracellular Vesicle in Obstetrics and Gynae-Oncology Group, UQ Centre for Clinical Research, Royal Brisbane and Women's Hospital, Faculty of Medicine, The University of Queensland, Australia"},{"name":"3Departamento de Investigaci\u00f3n, Postgrado y Educaci\u00f3n Continua (DIPEC), Facultad de Ciencias de la Salud, Universidad del Alba, Santiago, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"288","published-online":{"date-parts":[[2023,8,31]]},"reference":[{"key":"2023083111003933800_B1","doi-asserted-by":"crossref","first-page":"S173","DOI":"10.1016\/S0020-7292(15)30033-3","article-title":"The International Federation of Gynecology and Obstetrics (FIGO) Initiative on gestational diabetes mellitus: A pragmatic guide for diagnosis, management, and care","volume":"131","author":"Hod","year":"2015","journal-title":"Int. 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