Accessorily, HbA1c is a biomarker related to inflammation35, therefore high plasmatic levels of HbA1c may indicate active inflammation during pregnancy, which may be reduced by insulin therapy as insulin has anti-inflammatory effects in GDM.36 This indicates the clinical usefulness of baseline HbA1c in determining the level of risk of A2GDM in GDM patients to ensure closer monitoring of patients with high levels of HbA1c. This evidence concerns the gene INS and gestational diabetes.