{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T17:28:13Z","timestamp":1793035693389,"version":"4.5.0"},"reference-count":54,"publisher":"BMJ","issue":"8","funder":[{"DOI":"10.13039\/501100001826","name":"ZonMw","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001826","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2019,5,22]]},"published-print":{"date-parts":[[2019,8]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>In women with gestational diabetes mellitus (GDM) requiring pharmacotherapy, insulin was the established first-line treatment. More recently, oral glucose lowering drugs (OGLDs) have gained popularity as a patient-friendly, less expensive and safe alternative. Monotherapy with metformin or glibenclamide (glyburide) is incorporated in several international guidelines. In women who do not reach sufficient glucose control with OGLD monotherapy, usually insulin is added, either with or without continuation of OGLDs. No reliable data from clinical trials, however, are available on the effectiveness of a treatment strategy using all three agents, metformin, glibenclamide and insulin, in a stepwise approach, compared with insulin-only therapy for improving pregnancy outcomes. In this trial, we aim to assess the clinical effectiveness, cost-effectiveness and patient experience of a stepwise combined OGLD treatment protocol, compared with conventional insulin-based therapy for GDM.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The SUGAR-DIP trial is an open-label, multicentre randomised controlled non-inferiority trial. Participants are women with GDM who do not reach target glycaemic control with modification of diet, between 16 and 34 weeks of gestation. Participants will be randomised to either treatment with OGLDs, starting with metformin and supplemented as needed with glibenclamide, or randomised to treatment with insulin. In women who do not reach target glycaemic control with combined metformin and glibenclamide, glibenclamide will be substituted with insulin, while continuing metformin. The primary outcome will be the incidence of large-for-gestational-age infants (birth weight &gt;90th percentile). Secondary outcome measures are maternal diabetes-related endpoints, obstetric complications, neonatal complications and cost-effectiveness analysis. Outcomes will be analysed according to the intention-to-treat principle.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>The study protocol was approved by the Ethics Committee of the Utrecht University Medical Centre. Approval by the boards of management for all participating hospitals will be obtained. Trial results will be submitted for publication in peer-reviewed journals.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration number<\/jats:title>\n                    <jats:p>NTR6134; Pre-results.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2019-029808","type":"journal-article","created":{"date-parts":[[2019,8,19]],"date-time":"2019-08-19T06:00:44Z","timestamp":1566194444000},"page":"e029808","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":9,"title":["SUGAR-DIP trial: oral medication strategy versus insulin for diabetes in pregnancy, study protocol for a multicentre, open-label, non-inferiority, randomised controlled trial"],"prefix":"10.1136","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9159-8065","authenticated-orcid":false,"given":"Leon","family":"de Wit","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynaecology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Doortje","family":"Rademaker","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daphne N","family":"Voormolen","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bettina M C","family":"Akerboom","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Albert Schweitzer Hospital, Dordrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosalie M","family":"Kiewiet-Kemper","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Albert Schweitzer Hospital, Dordrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maarten R","family":"Soeters","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marion A L","family":"Verwij-Didden","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Bernhoven Hospital, Uden, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fahima","family":"Assouiki","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Bernhoven Hospital, Uden, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniela H","family":"Schippers","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Canisius Wilhelmina Hospital, Nijmegen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mechteld A R","family":"Vermeulen","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Canisius Wilhelmina Hospital, Nijmegen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simone M I","family":"Kuppens","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Catharina Hospital, Eindhoven, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mirjam M","family":"Oosterwerff","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Catharina Hospital, Eindhoven, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joost J","family":"Zwart","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Deventer Hospital, Deventer, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mattheus J M","family":"Diekman","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Deventer Hospital, Deventer, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tatjana E","family":"Vogelvang","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Diakonessenhuis Utrecht, Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P Rob J","family":"Gallas","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Diakonessenhuis Utrecht, Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sander","family":"Galjaard","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Prenatal Medicine, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Willy","family":"Visser","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Prenatal Medicine, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole","family":"Horree","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Flevoziekenhuis, Almere, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tamira K","family":"Klooker","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Flevoziekenhuis, Almere, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosemarie","family":"Laan","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Gelderse Vallei Hospital, Ede, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rik","family":"Heijligenberg","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Gelderse Vallei Hospital, Ede, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anjoke J M","family":"Huisjes","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Gelre Hospitals, Apeldoorn, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"van Bemmel","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Gelre Hospitals, Apeldoorn, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia A","family":"van Meir","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Groene Hart Hospital, Gouda, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annewieke W","family":"van den Beld","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Groene Hart Hospital, Gouda, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wietske","family":"Hermes","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Haaglanden Medical Center, The Hague, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Solrun","family":"Vidarsdottir","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Haaglanden Medical Center, The Hague, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anneke G","family":"Veldhuis-Vlug","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Medical Center Jan van Goyen, Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Remke C","family":"Dullemond","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Jeroen Bosch Hospital, \u2018s-Hertogenbosch, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henrique J","family":"Jansen","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Jeroen Bosch Hospital, \u2018s-Hertogenbosch, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marieke","family":"Sueters","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Leiden University Medical Center, Leiden, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eelco J P","family":"de Koning","sequence":"additional","affiliation":[{"name":"Department of Medicine, Leiden University Medical Center, Leiden, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Judith O E H","family":"van Laar","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, M\u00e1xima Medical Center, Veldhoven, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pleun","family":"Wouters-van Poppel","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, M\u00e1xima Medical Center, Veldhoven, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marina E","family":"Sanson-van Praag","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Meander Medical Center, Amersfoort, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eline S","family":"van den Akker","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, OLVG, Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine B","family":"Brouwer","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, OLVG, Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brenda B","family":"Hermsen","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, OLVG, Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bert Jan","family":"Potter van Loon","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, OLVG, Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olivier W H","family":"van der Heijden","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Radboud University Medical Center Nijmegen, Nijmegen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bastiaan E","family":"de Galan","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Radboud University Medical Center Nijmegen, Nijmegen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marsha","family":"van Leeuwen","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Reinier de Graaf Hospital, Delft, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johanna A M","family":"Wijbenga","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Reinier de Graaf Hospital, Delft, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karin","family":"de Boer","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Rijnstate Hospital, Arnhem, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arianne C","family":"van Bon","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Rijnstate Hospital, Arnhem, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Flip W","family":"van der Made","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Franciscus Gasthuis and Vlietland, Rotterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvia A","family":"Eskes","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Franciscus Gasthuis and Vlietland, Rotterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mirjam","family":"Zandstra","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Spaarne Gasthuis, Haarlem, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William H","family":"van Houtum","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Spaarne Gasthuis, Haarlem, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Babette A M","family":"Braams-Lisman","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Tergooi, Blaricum, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catharina R G M","family":"Daemen-Gubbels","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Tergooi, Blaricum, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maurice G A J","family":"Wouters","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Amsterdam UMC, VU University Medical Center, Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard G","family":"IJzerman","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Amsterdam UMC, VU University Medical Center, Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nico A","family":"Mensing van Charante","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Dijklander Hospital, Hoorn, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rolf","family":"Zwertbroek","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Dijklander Hospital, Hoorn, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Judith E","family":"Bosmans","sequence":"additional","affiliation":[{"name":"Department of Health Sciences, Faculty of Science, VU University Amsterdam, Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Inge M","family":"Evers","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Meander Medical Center, Amersfoort, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ben Willem","family":"Mol","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, School of Medicine, Monash University, Melbourne, Australia, Melbourne, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harold W","family":"de Valk","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Endocrinology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Floris","family":"Groenendaal","sequence":"additional","affiliation":[{"name":"Department of Neonatology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christiana A","family":"Naaktgeboren","sequence":"additional","affiliation":[{"name":"Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca C","family":"Painter","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J Hans","family":"deVries","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arie","family":"Franx","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bas B","family":"van Rijn","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands"},{"name":"Department of Obstetrics and Prenatal Medicine, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2019,8,18]]},"reference":[{"key":"2025121410205321000_9.8.e029808.1","doi-asserted-by":"publisher","DOI":"10.3109\/14767058.2011.587921"},{"key":"2025121410205321000_9.8.e029808.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2013.11.003"},{"key":"2025121410205321000_9.8.e029808.3","doi-asserted-by":"publisher","DOI":"10.1007\/s11892-015-0699-x"},{"key":"2025121410205321000_9.8.e029808.4","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-5491.2011.03541.x"},{"key":"2025121410205321000_9.8.e029808.5","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2393-12-23"},{"key":"2025121410205321000_9.8.e029808.6","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0707943"},{"key":"2025121410205321000_9.8.e029808.7","doi-asserted-by":"publisher","DOI":"10.1016\/S0020-7292(01)00496-9"},{"key":"2025121410205321000_9.8.e029808.8","doi-asserted-by":"publisher","DOI":"10.2337\/dc18-0048"},{"key":"2025121410205321000_9.8.e029808.9","doi-asserted-by":"publisher","DOI":"10.1038\/nrendo.2012.96"},{"key":"2025121410205321000_9.8.e029808.10","doi-asserted-by":"publisher","DOI":"10.2337\/dc18-2021"},{"key":"2025121410205321000_9.8.e029808.11","doi-asserted-by":"publisher","DOI":"10.1002\/dmrr.2275"},{"key":"2025121410205321000_9.8.e029808.12","doi-asserted-by":"publisher","DOI":"10.2337\/dc16-2397"},{"key":"2025121410205321000_9.8.e029808.13","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa042973"},{"key":"2025121410205321000_9.8.e029808.14","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0902430"},{"key":"2025121410205321000_9.8.e029808.15","unstructured":"The Royal Australian College of General Practitioners. General practice management of type 2 diabetes: 2016\u201318. East Melbourne, Vic: RACGP, 2016. https:\/\/www.racgp.org.au\/clinical-resources\/clinical-guidelines\/key-racgp-guidelines\/view-all-racgp-guidelines\/management-of-type-2-diabetes\/reproductive-health\/gestational-diabetes#ref-num-65 (Accessed 27 Mar 2019)."},{"key":"2025121410205321000_9.8.e029808.16","doi-asserted-by":"crossref","first-page":"e49","DOI":"10.1097\/AOG.0000000000002501","article-title":"Committee on Practice Bulletins-Obstetrics. ACOG Practice Bulletin No. 190: Gestational Diabetes Mellitus","volume":"131","year":"2018","journal-title":"Obs Gynecol"},{"key":"2025121410205321000_9.8.e029808.17","doi-asserted-by":"publisher","DOI":"10.2337\/dc18-S013"},{"key":"2025121410205321000_9.8.e029808.18","unstructured":"Nederlandse Vereniging Voor Obstetrie en Gynaecologie. DIABETES MELLITUS EN ZWANGERSCHAP Versie 2.0. 2010 http:\/\/www.nvog-documenten.nl\/index.php?pagina=\/richtlijn\/item\/pagina.php&richtlijn_id=863 (accessed 26 Oct 2016)."},{"key":"2025121410205321000_9.8.e029808.19","unstructured":"National Institute for Health and Care Excellence. Diabetes in pregnancy: management from preconception to the postnatal period. 2015:2\u201365 https:\/\/www.nice.org.uk\/guidance\/ng3 (accessed 8 Nov 2018)."},{"key":"2025121410205321000_9.8.e029808.20","doi-asserted-by":"crossref","first-page":"1484","DOI":"10.1016\/j.jogc.2018.06.024","article-title":"New Diabetes Canada Clinical Practice Guidelines for Diabetes and Pregnancy \u2013 What\u2019s Changed?","volume":"40","author":"Keely","year":"2018","journal-title":"Journal of Obstetrics and Gynaecology Canada"},{"key":"2025121410205321000_9.8.e029808.21","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2018.01.041"},{"key":"2025121410205321000_9.8.e029808.22","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200010193431601"},{"key":"2025121410205321000_9.8.e029808.23","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0707193"},{"key":"2025121410205321000_9.8.e029808.24","doi-asserted-by":"crossref","first-page":"490","DOI":"10.1016\/j.ajog.2018.01.024","article-title":"Pharmacological treatment of gestational diabetes mellitus: point\/counterpoint","volume":"218","author":"Langer","year":"2018","journal-title":"Am J Obstet Gynecol"},{"key":"2025121410205321000_9.8.e029808.25","doi-asserted-by":"crossref","first-page":"S173","DOI":"10.1016\/S0020-7292(15)30007-2","article-title":"The International Federation of Gynecology and Obstetrics (FIGO) Initiative on gestational diabetes mellitus: A pragmatic guide for diagnosis, management, and care","volume":"131 Suppl","author":"Hod","year":"2015","journal-title":"Int J Gynaecol Obs"},{"key":"2025121410205321000_9.8.e029808.26","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000000285"},{"key":"2025121410205321000_9.8.e029808.27","first-page":"CD011967","article-title":"Oral anti-diabetic pharmacological therapies for the treatment of women with gestational diabetes","volume":"1","author":"Brown","year":"2017","journal-title":"Cochrane Database Syst Rev"},{"key":"2025121410205321000_9.8.e029808.28","first-page":"CD012037","article-title":"Insulin for the treatment of women with gestational diabetes","volume":"11","author":"Brown","year":"2017","journal-title":"Cochrane Database Syst Rev"},{"key":"2025121410205321000_9.8.e029808.29","doi-asserted-by":"crossref","first-page":"1678","DOI":"10.1007\/s10995-017-2261-8","article-title":"\u2018It\u2019s a Very Big Burden on Me\u2019: Women\u2019s Experiences Using Insulin for Gestational Diabetes","volume":"21","author":"Figueroa Gray","year":"2017","journal-title":"Matern Child Health J"},{"key":"2025121410205321000_9.8.e029808.30","doi-asserted-by":"crossref","first-page":"227","DOI":"10.1517\/14740338.2011.521740","article-title":"Oral hypoglycemic agents for gestational diabetes mellitus?","volume":"10","author":"Maymone","year":"2011","journal-title":"Expert Opin Drug Saf"},{"key":"2025121410205321000_9.8.e029808.31","doi-asserted-by":"publisher","DOI":"10.1053\/j.semperi.2014.08.012"},{"key":"2025121410205321000_9.8.e029808.32","doi-asserted-by":"publisher","DOI":"10.1177\/1474651413493933"},{"key":"2025121410205321000_9.8.e029808.33","doi-asserted-by":"publisher","DOI":"10.1023\/A:1026485130100"},{"key":"2025121410205321000_9.8.e029808.34","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.h102"},{"key":"2025121410205321000_9.8.e029808.35","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000129239.82126.a1"},{"key":"2025121410205321000_9.8.e029808.36","doi-asserted-by":"crossref","first-page":"1811","DOI":"10.1007\/s13300-018-0479-0","article-title":"Long-Term Effects of Oral Antidiabetic Drugs During Pregnancy on Offspring: A Systematic Review and Meta-analysis of Follow-up Studies of RCTs","volume":"9","author":"van Weelden","year":"2018","journal-title":"Diabetes Ther"},{"key":"2025121410205321000_9.8.e029808.37","doi-asserted-by":"publisher","DOI":"10.2337\/dc16-2307"},{"key":"2025121410205321000_9.8.e029808.38","unstructured":"Zorgevaluatie Nederland. Nederlandse Vereniging voor Obstetrie en Gynaecologie. http:\/\/www.zorgevaluatienederland.nl\/associations\/1 (Accessed 4 Feb 2019)."},{"key":"2025121410205321000_9.8.e029808.39","unstructured":"Netherlands Trial Register (NTR): The SUGAR-DIP trial; oral medication strategy versus insulin for diabetes in pregnancy. https:\/\/www.trialregister.nl\/trial\/5953 (Accessed 29 Jan 2019)."},{"key":"2025121410205321000_9.8.e029808.40","doi-asserted-by":"crossref","first-page":"1773","DOI":"10.1001\/jama.2018.4072","article-title":"Effect of Glyburide vs Subcutaneous Insulin on Perinatal Complications Among Women With Gestational Diabetes: A Randomized Clinical Trial","volume":"319","author":"S\u00e9nat","year":"2018","journal-title":"JAMA"},{"key":"2025121410205321000_9.8.e029808.41","unstructured":"Nederlandse Internisten Vereeniging (NIV). Diabetes en Zwangerschap. 2007."},{"key":"2025121410205321000_9.8.e029808.42","doi-asserted-by":"publisher","DOI":"10.1542\/peds.105.5.1141"},{"key":"2025121410205321000_9.8.e029808.43","doi-asserted-by":"publisher","DOI":"10.1016\/j.earlhumdev.2009.09.008"},{"key":"2025121410205321000_9.8.e029808.44","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-5491.1990.tb01421.x"},{"key":"2025121410205321000_9.8.e029808.45","unstructured":"Bradley C . Handbook of psychology and diabetes: a guide to psychological measurement in diabetes research and practice. Chur, Switzerland: Harwood Academic Publishers, 1994."},{"key":"2025121410205321000_9.8.e029808.46","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2004.11.010"},{"key":"2025121410205321000_9.8.e029808.47","doi-asserted-by":"crossref","first-page":"401-4","DOI":"10.1111\/j.1365-2125.1994.tb05705.x","article-title":"International conference on harmonisation of technical requirements for registration of pharmaceuticals for human use (ICH)","volume":"37","author":"Baber","year":"1994","journal-title":"Br J Clin Pharmacol"},{"key":"2025121410205321000_9.8.e029808.48","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.i4338"},{"key":"2025121410205321000_9.8.e029808.49","unstructured":"Zorginstituut Nederland. Richtlijn Voor Het Uitvoeren van Economische Evaluaties in de Gezondheidszorg. Diemen 2015."},{"key":"2025121410205321000_9.8.e029808.50","doi-asserted-by":"publisher","DOI":"10.1007\/s11136-011-9903-x"},{"key":"2025121410205321000_9.8.e029808.51","doi-asserted-by":"crossref","unstructured":"Bouwmans C , Hakkaart- van Roijen L , Koopmanschap M , et al . Manual iMTA Productivity Cost Questionnaire (iPCQ). Rotterdam: Institute for Medical Technology Assessment Erasmus Universiteit Rotterdam, 2013.","DOI":"10.1016\/j.jval.2014.08.1791"},{"key":"2025121410205321000_9.8.e029808.52","unstructured":"Bouwmans C , Hakkaart- van Roijen L , Koopmanschap M , et al . Manual iMTA Medical Consumption Questionnaire (iMCQ). Rotterdam: Institute for Medical Technology Assessment Erasmus Universiteit Rotterdam, 2013."},{"key":"2025121410205321000_9.8.e029808.53","doi-asserted-by":"publisher","DOI":"10.1002\/hec.903"},{"key":"2025121410205321000_9.8.e029808.54","unstructured":"Zorgevaluatie Nederland. Zorgevaluatie Nederland Study website: SUGAR-DIP trial. http:\/\/www.zorgevaluatienederland.nl\/projects\/29\/downloads-and-links (Accessed 4 Feb 2019)."}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2019-029808","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,14]],"date-time":"2025-12-14T18:21:03Z","timestamp":1765736463000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2019-029808"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,8]]},"references-count":54,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2019,8,18]]},"published-print":{"date-parts":[[2019,8]]}},"alternative-id":["10.1136\/bmjopen-2019-029808"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2019-029808","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,8]]}}}