Gestational Diabetes

A 28-year-old primigravida at 24 weeks of gestation is diagnosed with gestational diabetes mellitus (GDM) on 75-g oral glucose tolerance test (OGTT). Regarding the management and screening of GDM, all of the following statements are true EXCEPT:

A 32-year-old multiparous woman with GDM diagnosed at 26 weeks is counselled on maternal and fetal complications. Regarding the complications and long-term sequelae of GDM, all of the following are associated with GDM EXCEPT:

A 32-year-old multigravida at 32 weeks of gestation with known gestational diabetes mellitus (diagnosed at 24 weeks) presents for routine follow-up. She has been on medical nutrition therapy for 6 weeks. Her home blood glucose log shows: fasting 98–102 mg/dL, 2-hour postprandial 155–165 mg/dL. She is compliant with diet and exercise. What is the most appropriate next step in management?

A 28-year-old primigravida from Delhi presents at 24 weeks gestation for routine antenatal care. She is asymptomatic with a BMI of 26 kg/m². Her fasting blood glucose is 95 mg/dL and 2-hour post-75 g oral glucose tolerance test (OGTT) value is 168 mg/dL. Her HbA1c is 5.8%. What is the most appropriate next step in management?

A 32-year-old multiparous woman from Mumbai is diagnosed with gestational diabetes at 26 weeks gestation. She has been on medical nutrition therapy for 2 weeks with home glucose monitoring. Her fasting glucose readings are consistently 110–125 mg/dL and 2-hour postprandial readings are 155–175 mg/dL, both above target. She is overweight (BMI 28 kg/m²) and has no contraindications to insulin or metformin. What is the most appropriate next step?