Furthermore, patients in therapy with insulin were significantly more affected by chronic hypertension (0.5 vs 3.2%, p < 0.001) and hypothyroidism (6.1 vs 9.9%, p 0.002), and their pregnancy was more likely achieved using assisted reproductive technology (ART) (4.2 vs 7.3%, p 0.003). This evidence concerns the gene INS and hypothyroidism.