INS and gestational diabetes: Gupta et al showed that 79% doctors preferred insulin as the treatment of choice.11 A review article showed that evidence suggests that metformin has proved to be a very effective option in providing good blood sugar control, good safety and outcomes are improved when Insulin is supplemented with metformin.13 However health care providers in our setting appear to be reluctant in using metformin as an alternate to insulin reflecting an apparent gap in up to date knowledge regarding GDM management.