IGF1 and gestational diabetes: Studies have reported that poor gestational glycemic control can cause vascular damage in the developing inner ear.25,26 Furthermore, 1 more study suggested that increased insulin-like growth factor-1 can modify cochlear morphogenesis.27 Children with diabetic pregnancies were more likely to have high-frequency hearing loss with a severity of moderate to profound and sensorineural in nature.18 These conjectures indicate that children with GDM pregnancies may have impaired hearing sensitivity.