INS and coronary artery disorder: There is a clear pathophysiological connection between maternal insulin resistance and foetal CHDs, with glucose-mediated mechanisms of CHD involving multiple developmental pathways [59]: comprise left-right patterning [60], alterations in neural crest cells migration and formation [61, 62], increased apoptosis [63, 64] as well as changes in nitric oxide signalling [65], and impaired autophagy [66].