In their population in the USA, the proportions of women with insulin-resistant GDM (51%), insulin-insufficient GDM (30%) were similar to those for our cohort; however, the proportion of women categorised as having GDM with both insulin resistance and insulin insufficiency differed (18% GDM-mixed [the category referred to as ‘GDM-both’ in our study]), and only one woman was unclassified, compared with 71 (25.3%) in our study [4]. Here, INS is linked to Insulin resistance.