INS and diabetes mellitus: The membranes of primiparous patients had a significantly lower applied force before rupture compared to multiparous patients (2.16 N vs. 2.77 N, p = 0.02) and the membranes of patients with gestational diabetes, with or without insulin, had a greater applied force before rupture than patients without diabetes (3.02 N vs. 2.42 N, p = 0.033) (Table 4).