INS and gestational diabetes: Notably, the majority of women (70% – 85%) with GDM can be successfully treated with a healthy lifestyle, proper exercise and dietary modifications.11 More than 15% to 30% of these women usually do not need insulin therapy.12 Furthermore, a caesarean section is indicated for gestational diabetes because of the increased risk of shoulder dystocia and brachial plexus paralysis.8,13