In the last “Italian Standards of Medical Care 2018” document (siditalia.it; last accessed: 29 July 2023), insulin is indicated as the first-line pharmacological therapy for the treatment of GDM when, after two weeks of being diagnosed with GDM, diet and exercise are insufficient to achieve fasting and postprandial glycemic control, whereas metformin is not recommended. Here, INS is linked to gestational diabetes.