INS and Hyperbilirubinemia: Similarly, in a retrospective cohort study that evaluated 820 women with GDM in the Netherlands, no significant differences were observed in perinatal complications (mortality, birth injury, hyperbilirubinemia, hypoglycemia) as well as in the rates of LGA neonates, fetal macrosomia, Apgar < 7 on 5° minute, need for respiratory support, preterm birth and admission to neonatal ICU between the group treated with diet alone and the group treated with insulin.6