In comparison to insulin, not only has metformin been associated with a lower risk of neonatal hypoglycaemia and maternal weight-gain in systematic reviews, [22, 23] it is less expensive and has fewer education requirements, potentially making metformin prescribing less susceptible to the barriers we identified in insulin provision, such as: workforce shortages, lack of confidence with insulin initiation/escalation and language barriers. The gene discussed is INS; the disease is Hypoglycemia.