"Being able to accurately predict insulin requirements could improve early glycemic control in GDM. Clinical approaches to initial insulin dose selection and insulin titration vary very widely among hospitals,2 and across guidelines, with several current protocols recommending using a pre-pregnancy weight-based or body mass index (BMI)-based insulin dose selection. However, few comparative studies have evaluated different approaches to insulin dose selection and titration,3 and it remains unclear whether weight or BMI are accurate predictors of insulin requirement in GDM. Therefore, there is a need for an evidence-based approach to insulin dosing in GDM, which is essential to prevent complications and minimize care variation."