Hi, we recently had a review of your article in our institution and came up with certain queries we would like you to kindly clarify.

1. The title of the study “ Metformin versus Insulin in the Management of Pre-gestational Diabetes mellitus in Pregnancy and Gestational Diabetes Mellitus “ indicates in a way that the study design employed is a factorial design, in contrary to the design employed in the study which was a parallel design.

2. Can you please provide the explanation regarding the inclusion and exclusion of Type 2 DM patient on oral hypoglycemic agents other than metformin and on Insulin.

3. The number of patients enrolled initially, the number who fit the inclusion criteria , the number excluded was not mentioned

4.According to the chart, the number of patients given supplemental insulin were two and one was switched to supplemental insulin. In the discussion it was mentioned that two patients were started on supplemental insulin as they were unable to reach their glycemic targets on Metformin and two were switched to insulin inadvertently due to clinician errors. There is a discrepancy in the number mentioned in the chart and the discussion.

5. Adjustment analysis like Bonferoni test was mentioned in the methodology, but there was no mention of the test being done at any point in the results. The independent samples t-test title indicates mean glycemic profile from enrolment till term, but the mean values mentioned in the table seem to correspond to only term values rather than the mean values from enrolment till term

6. The conclusion of the study could have been based preferably on repeated measures ANOVA since three different points of time are being considered, rather than a single mean value comparison using independent samples t test.