INS and Large for gestational age: While birthweight was higher and macrosomia was more frequent in the expectantly managed group, no other significant differences between groups were noted.11 In the other study, Worda et al randomized 100 women with insulin-treated gestational diabetes to labor induction at 38 weeks or expectant management until 40 weeks.14 The risks of large for gestational age and cesarean section were similar between the 2 groups, although neonatal hypoglycemia was increased in the 38-week group.