PROJECT

Role of Early Pharmacological Therapy and Strict Glycaemic Control in Pregnant Women with Hyperglycaemia: A Systematic Review and Meta-Analysis

May 2026 - October 2026

Objectives:

To evaluate the effectiveness of early initiation of pharmacological therapy along with strict glycaemic targets in improving glycaemic control and reducing adverse maternal and neonatal outcomes among pregnant women with hyperglycaemia.

Study Overview:

This systematic review and meta-analysis will synthesize available evidence regarding the effectiveness of early initiation of pharmacological therapy along with strict glycaemic targets compared with delayed pharmacological treatment or less stringent glycaemic targets among pregnant women with hyperglycaemia.

Study Approach:

This review will include randomized controlled trials, quasi-experimental studies and prospective or retrospective cohort studies. The population will include pregnant women with hyperglycaemia, including GDM and pre-existing T2DM. The intervention will include early initiation of pharmacological therapy (insulin/metformin) when indicated along with strict glycaemic targets.

Expected Public Health Impact:

Pregnant women with hyperglycaemia are at increased risk of complications such as preeclampsia, caesarean section, preterm birth, fetal macrosomia, neonatal hypoglycaemia, congenital anomalies and perinatal mortality.