In adjusted analysis, the risk of insulin-requiring GDM was associated with a positive history of GDM (OR=5.68, 95% CI = 2.72-11.83) and HbA1c 6.6-7% (OR=2.96, 95% CI = 1.03-8.50) and >7% (OR=7.60, 95% CI = 2.68-21.54). The gene discussed is INS; the disease is gestational diabetes.