Gestational diabetes & diabetes in pregnancy
Pharmacological Treatment for Gestational Diabetes Mellitus: A Systematic Review and Network Meta‐Analysis of 71 Randomised Controlled Trial
Authors' conclusion
Insulin use provides significant benefits in achieving glycaemic control and minimising maternal and foetal complications, and it has a favourable overall safety profile. Biguanide use may be associated with an increased risk of low birth weight
Study context
- Population
- Patients with gestational diabetes mellitus (GDM) in randomised controlled trials (RCTs) evaluating glucose levels and maternal or neonatal complications; databases searched up to May 16, 2025
- Participants
- 14,877 patients71 trials
- Comparison
- Pharmacologic treatments vs standard care
- Outcome
- Fasting glucose
Methodological detailsrandom-effects model, frequentist network meta-analysis, Confidence in Network Meta-Analysis (CINeMA) certainty assessment
- Random-effects model
- Frequentist network meta-analysis
- CINeMA certainty assessment
Pooled result
As reported in the abstract
Each group vs standard careMD, mmol/L (95% CI)
Sulfonylureas
−0.33(−0.55 to −0.1)
Insulin
−0.3(−0.4 to −0.21)
Biguanides
−0.2(−0.28 to −0.12)
Further pooled results
| Outcome | MD (%) (95% CI) | |
|---|---|---|
| HbA1cBiguanidesvs Standard care | −0.1 (−0.16 to −0.03) | |
| −0.2−0.100.1Difference, % (linear scale) |
| Outcome | OR (95% CI) | |
|---|---|---|
| MacrosomiaInsulinvs Standard care | 0.51 (0.34–0.75) | |
| MacrosomiaBiguanidesvs Standard care | 0.39 (0.26–0.59) | |
| MacrosomiaSulfonylureasvs Standard care | 0.5 (0.31–0.79) | |
| 0.20.5125Odds ratio (log scale) |
Safety
| Outcome | OR (95% CI) | |
|---|---|---|
| Low birth weightBiguanidesvs Standard care | 2.04 (1.04–4.01) | |
| 0.20.5125Odds ratio (log scale) |
Premature delivery and neonatal hypoglycaemia
- Sulfonylureas were found to be more easily get premature delivery and neonatal hypoglycaemia than biguanides
Original publication
Pharmacological Treatment for Gestational Diabetes Mellitus: A Systematic Review and Network Meta‐Analysis of 71 Randomised Controlled Trial. Diabetes Obes Metab. Published 4 May 2026. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →