Management of gestational diabetes involved exogenous insulin in only 8–20% of women in two recent large multi-center treatment studies [the Maternal-Fetal Medicine Units (MFMU) study (23) (23) and the ACHOIS study (5)] so the great majority of women with gestational diabetes have improved outcomes with diet, lifestyle modification, oral hypoglycemic drugs and glucose monitoring alone. The gene discussed is INS; the disease is gestational diabetes.