INS and gestational diabetes: Two randomized trials considered 4- to 9-year-old metformin-exposed children of mothers with gestational diabetes (GDM) or PCOS to acquire some long-term metabolic programming effects such as higher BMI and increased prevalence of overweight or obesity [220, 221].On the other hand, a study including 1,996 children exposed to metformin during the fetal period and 1,932 treated with insulin showed no differences in either child growth or neurodevelopment between both the groups [222].