A study by Clark et al in 1997 in 179 women (52 who developed GDM and 127 who did not) who had positive 1 hour screening tests at between 16 and 33 weeks gestation demonstrated that a combination of fasting and 2-hour insulin levels, fasting free fatty acids and fasting β-hydroxybutyrate were all statistically significant individually and jointly in terms of predictive value lending to the argument that GDM is an insulin-resistant state.34 The gene discussed is INS; the disease is gestational diabetes.