INS and gestational diabetes: Furthermore, in a population-based cohort study in New Zealand in patients with GDM treated with metformin or insulin, the Strengths and Difficulties Questionnaire was used to assess the difference in behavioral development before entering school between the offspring (n = 3928) of the 2 medication groups.24 In that study, the proportion of children having concerning scores in the Strengths and Difficulties Questionnaire and prosocial behavior scores were similar in parent and teacher ratings between the 2 groups.