They further discuss that where maternal
hyperglycaemia cannot be controlled through dietary and exercise modifications, and blood glucose
levels remain elevated, insulin is added for greater control (Tieu et al. 2011, p. 4). A Cochrane
Systematic Review by Farrar, Tuffnell and West (2007) looks at continuous insulin infusions versus
multiple daily injections of insulin, as well the use of oral hypoglycaemic medication such as
metformin for treatment as an alternative to insulin, which showed no significant difference in
primary outcomes. The woman in consultation with her obstetrician would need to discuss the best
option for her based on her own personal circumstances and what hospital policy and evidence
based research recommends at the time.