INS and Hyperglycemia: Thus, macrosomia is a frequent complication in pregnant women with diabetes, which is potentially harmful for both the mother and the fetus, with risk of traumas in childbirth, fetal hypoxia (and even neonatal death), perineal laceration, uterine atony, and severe hemorrhagy.53 Hyperglycemia is considered a changeable risk factor for macrosomia.54 On the present systematic review, there was no difference between the use of insulin analogs and the use of human insulins regarding macrosomia, reaffirming the importance of avoiding hyperglycemia during pregnancy.