What do systematic reviews say?

Self‐monitoring vs periodic

Self‐monitoring showed no clear difference in large‐for‐gestational age compared with periodic (low certainty).

• Different methods and settings for glucose monitoring for gestational diabetes during pregnancy 2017 · Cochrane Headline outcomes only
  RR 0.82 [0.5, 1.37]
  2 studies · 400 participants
  Low

Continuous glucose monitoring system vs self‐monitoring of glucose

It is very uncertain whether continuous glucose monitoring system changes large‐for‐gestational age compared with self‐monitoring of glucose (very low certainty).

• Different methods and settings for glucose monitoring for gestational diabetes during pregnancy 2017 · Cochrane Headline outcomes only
  RR 0.67 [0.43, 1.05]
  1 study · 106 participants
  Very low

Telemedicine vs usual care

It is very uncertain whether telemedicine changes large‐for‐gestational age compared with standard care (very low certainty).

• Different methods and settings for glucose monitoring for gestational diabetes during pregnancy 2017 · Cochrane Headline outcomes only
  RR 1.41 [0.76, 2.64]
  3 studies · 228 participants
  Very low

Metformin vs glibenclamide ‐ neonatal outcomes

Metformin showed no clear difference in large‐for‐gestational age compared with glibenclamide ‐ neonatal outcomes (low certainty).

• Oral anti‐diabetic pharmacological therapies for the treatment of women with gestational diabetes 2017 · Cochrane Headline outcomes only
  RR 0.67 [0.24, 1.83]
  2 studies · 246 participants
  Low

Glibenclamide vs acarbose ‐ neonatal outcomes

Glibenclamide showed no clear difference in large‐for‐gestational age compared with acarbose ‐ neonatal outcomes (low certainty).

• Oral anti‐diabetic pharmacological therapies for the treatment of women with gestational diabetes 2017 · Cochrane Headline outcomes only
  RR 2.38 [0.54, 10.46]
  1 study · 43 participants
  Low

Oral anti‐diabetic pharmacological therapies vs placebo (outcomes

It is very uncertain whether oral anti‐diabetic pharmacological therapies changes large‐for‐gestational age compared with placebo ‐ neonatal outcomes (very low certainty).

• Oral anti‐diabetic pharmacological therapies for the treatment of women with gestational diabetes 2017 · Cochrane Headline outcomes only
  RR 0.89 [0.51, 1.58]
  1 study · 375 participants
  Very low

Lifestyle vs control ‐ Neonatal and later outcomes

Lifestyle probably leads to lower large‐for‐gestational age compared with control ‐ Neonatal and later outcomes (moderate certainty).

• Lifestyle interventions for the treatment of women with gestational diabetes 2017 · Cochrane Headline outcomes only
  RR 0.6 [0.5, 0.71]
  6 studies · 2994 participants
  Moderate

CSII vs MDI: infant outcomes

The review found no eligible studies for this question.

• Continuous subcutaneous insulin infusion versus multiple daily injections of insulin for pregnant women with diabetes 2016 · Cochrane Headline outcomes only
  no estimate extracted
  Studies not reported
  No studies found

Very tight vs tight‐moderate glycaemic control (infant outcomes)

The review found no eligible studies for this question.

• Different intensities of glycaemic control for pregnant women with pre‐existing diabetes 2016 · Cochrane Headline outcomes only
  no estimate extracted
  Studies not reported
  No studies found

Myo‐inositol vs placebo

Myo‐inositol showed no clear difference in large‐for‐gestational age compared with placebo (low certainty).

• Dietary supplementation with myo‐inositol in women during pregnancy for treating gestational diabetes 2016 · Cochrane Headline outcomes only
  RR 0.36 [0.02, 8.58]
  1 study · 73 participants
  Low

Probiotics vs placebo

Probiotic showed no clear difference in large‐for‐gestational age > 90 centile compared with placebo (low certainty).

• Probiotic treatment for women with gestational diabetes to improve maternal and infant health and well‐being 2020 · Cochrane Headline outcomes only
  RR 0.73 [0.35, 1.52]
  2 studies · 174 participants
  Low

Exercise vs control

The review found no eligible studies for this question.

• Exercise for pregnant women with gestational diabetes for improving maternal and fetal outcomes 2017 · Cochrane Headline outcomes only
  no estimate extracted
  Studies not reported
  No studies found

Tape measurement vs clinical palpation

The review found no eligible studies for this question.

• Symphysial fundal height (SFH) measurement in pregnancy for detecting abnormal fetal growth 2015 · Cochrane Headline outcomes only
  no estimate extracted
  Studies not reported
  No studies found

Insulin vs anti‐diabetic agent

Insulin showed no clear difference in large‐for‐gestational age (birthweight > 90th centile) compared with anti‐diabetic agent (moderate certainty).

• Insulin for the treatment of women with gestational diabetes 2017 · Cochrane Headline outcomes only
  RR 1.01 [0.76, 1.35]
  13 studies · 2352 participants
  Moderate

Tight vs moderate glycaemic control (infant outcomes)

• Different intensities of glycaemic control for pregnant women with pre‐existing diabetes 2016 · Cochrane Headline outcomes only
  no estimate extracted
  1 study · 45 participants
  Very low

Tight‐moderate vs loose glycaemic control (infant outcomes)

Tight‐moderate may leads to lower large‐for‐gestational age (birthweight > 90th centile) compared with loose glycaemic control (infant outcomes) (low certainty).

• Different intensities of glycaemic control for pregnant women with pre‐existing diabetes 2016 · Cochrane Headline outcomes only
  RR 0.01 [0, 0.2]
  1 study · 60 participants
  Low

Metformin vs placebo

Metformin showed no clear difference in large‐for‐gestational‐age infant, defined as birthweight ≥ 90th… compared with placebo (high certainty).

• Metformin for women who are overweight or obese during pregnancy for improving maternal and infant outcomes 2018 · Cochrane Headline outcomes only
  RR 0.95 [0.7, 1.3]
  2 studies · 831 participants
  High