Gestational diabetes & diabetes in pregnancy
A Systematic Review Supporting the Clinical Practice Guidelines on the Management of Preexisting Diabetes and Pregnancy
An erratum to this article was published (J Clin Endocrinol Metab, 16 Sep 2025 ↗)
Authors' conclusion
This systematic review addresses various aspects of managing PDM in pregnancy and will support the development of the Endocrine Society guidelines.
Study context
- Population
- Women with preexisting DM (preexisting diabetes mellitus (PDM)) in pregnancy17 studies
Methodological detailspairs of independent reviewers, MEDLINE, EMBASE, Scopus and other sources through February 2025
- Pairs of independent reviewers
- MEDLINE, EMBASE, Scopus and other sources through February 2025
Pooled result
As reported in the abstract
- HCL vs standard of care: no significant difference in time in range (TIR), time above range (TAR) and time below range (TBR)
- HCL had better overnight TIR and TBR
- T2D: intermittent continuous glucose monitoring (CGM) not associated with a significant change in risk of large for gestational age (LGA) neonates (2 RCTs, 102 patients)
- Adding metformin to insulin associated with lower risk of LGA (2 RCTs, 1126 patients)
- Induced delivery before 39 weeks (particularly before 38 weeks) in preexisting T1D and T2D: increased neonatal complications suggested (3 retrospective studies, 1724 patients); likely confounding
- Periconceptional GLP-1 RA exposure: no increase in neonatal complications (1 retrospective study)
- No comparative studies identified on a pregnancy-possibility screening question or carbohydrate restrictive diet
Original publication
A Systematic Review Supporting the Clinical Practice Guidelines on the Management of Preexisting Diabetes and Pregnancy. J Clin Endocrinol Metab. Published 13 July 2025. doi:10.
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