Studies are needed to support optimal insulin dose titration in gestational diabetes mellitus: A systematic review.

BACKGROUND AND AIMS:We aimed to summarise the existing literature on insulin dose titration in gestation diabetes. METHODS:Databases: Medline, EMBASE, CENTRAL and CINAHL were systematically searched for trials and observational studies comparing insulin titration strategies in gestational diabetes. RESULTS:No trials comparing insulin dose titration strategies were identified. Only one small (n = 111) observational study was included. In this study, patient-led daily basal insulin titration was associated with higher insulin doses, tighter glycaemic control, and lower birthweight, vs weekly clinician-led titration. CONCLUSIONS:There is a paucity of evidence to support optimal insulin titration in gestational diabetes. Randomized trials are required.