The proportion of women in this sample developing type 2 diabetes was similar to that observed in a number of previous studies, which report between 10% and 20% of women with GDM developing type 2 diabetes over similar follow-up periods of around 10 years.35–37 There was also no evidence that fasting glucose at the time of GDM diagnosis or insulin use, as indicators of the severity of insulin resistance, modified associations between antenatal CMD and type 2 diabetes. Here, INS is linked to Insulin resistance.