Use of insulin therapy (pooled OR 6.3 (95% CI 3.9–10.2), p < 0.001), multiparity (pooled OR 1.88 (95% CI 1.09–3.24), p < 0.02) and fetal macrosomia (pooled OR 1.63 (95% CI 1.25–2.13), p < 0.001) were also noted to increase the risk of GDM recurrence in a subsequent pregnancy [14]. Here, INS is linked to gestational diabetes.