Insulin therapy, in particular, suggests worsening hyperglycaemia and impaired P-cell function, emphasising the need for early detection in this vulnerable group.9 This finding aligns with a report from Johor, which also linked insulin use with an increased risk of postpartum glucose intolerance.6 Additionally, a German study reported that 92.3% of women using insulin during pregnancy developed diabetes within 15 years,26 while a Chinese study suggested that insulin use during pregnancy raises the risk of GDM in future pregnancies.27 This evidence concerns the gene INS and diabetes mellitus.