INS and Hypoglycemia: Glyburide can stimulate the release of insulin from the pancreas and it is a second-generation sulfonylureas that can be considered safe and effective for the treatment of GDM.[9] At present, there are some concerns regarding a higher risk of macrosomia, large-for-gestational age infants, and neonatal hypoglycemia compared to insulin.[10] Based on the controversy above, we performed a protocol for systematic review and metaanalysis to evaluate the efficacy and safety of glyburide, metformin, and insulin in treatment of GDM.