Inclusion Criteria:  Pregnant women who have completed a HbA1c test during the first 20 weeks of pregnancy.  Risk for GDM including any of the following:  Obese History of GDM History of macrosomia Twin gestation PCOS Family history of diabetes  Exclusion Criteria:  • Pregnant women who have not completed a HbA1c test during the first 20 weeks of pregnancy.  women with pre-gestational diabetes nonviable pregnancy fetal anomalies