Context

Insulin therapy is recommended as a first-line approach after failure of diet therapy to manage gestational diabetes (GDM).1 ,2 Not all women are suitable candidates or decline to use insulin to manage their blood glucose levels and alternative options are needed. Metformin and glibenclamide are mentioned as alternatives to insulin for management of gestational diabetes mellitus (GDM) in several guidelines,1 ,2 while National Institute for Health and Care Excellence guidelines recommend metformin as a first-line.3 This systematic review and meta-analysis examines the short-term maternal and neonatal outcomes in women with GDM receiving glibenclamide, metformin or insulin in randomised controlled trials (RCTs). …