INS and Large for gestational age: However, the systematic review by Sheng et al., in 2023,(25) analyzed 22 studies involving 4174 newborns and demonstrated that newborns whose mothers were treated with metformin had a 30% reduced risk of macrosomia compared to the insulin therapy group in 20 studies (RR 0.75; 95% CI 0.54, 0.86; I2 = 17%; p = 0.001).(25)