A client with gestational diabetes asks the nurse about the preferred medication for controlling blood sugar levels.

The nurse explains that the preferred medication is chosen because it does not cross the placenta and affect the baby.

Which medication is the nurse referring to?

The correct answer is choice D. 2400 calories.A pregnant woman with gestational diabetes should consume about 2400 calories per day during the third trimester of pregnancy.This is based on the average energy requirement for a pregnant woman, which is about 2200 calories per day plus 200 calories for the baby’s growth.

A woman who is overweight before pregnancy may need fewer calories than this.

Choice A. 1800 calories is wrong because it is too low for a pregnant woman with gestational diabetes.Eating too few calories can cause ketones to build up in the blood, which can harm the baby.

Choice B. 2000 calories is wrong because it is also too low for a pregnant woman with gestational diabetes.It may not provide enough energy and nutrients for the mother and the baby.

Choice C. 2200 calories is wrong because it is the average energy requirement for a pregnant woman without gestational diabetes.A woman with gestational diabetes needs an extra 200 calories per day to support the baby’s growth and development.

The correct answer is choice C. They are used in cases where diet and exercise are not sufficient to control blood sugar levels.According to a study by Langer et al, oral antidiabetic drugs such as glyburide and metformin are equivalent to insulin in terms of pregnancy outcomes in gestational diabetes mellitus (GDM).These drugs can help lower blood sugar levels by stimulating the release of insulin from the pancreas, limiting the liver’s production of glucose, or improving the cells’ sensitivity to insulin.

Choice A is wrong because they are not the first-line treatment option for gestational diabetes.The first-line treatment is diet and exercise, which can help control blood sugar levels in most cases of GDM.

Choice B is wrong because they are not necessarily contraindicated during pregnancy.Although there are some potential risks to the baby, such as hypoglycemia or fetal growth restriction, these can be minimized by careful monitoring and dose adjustment.

Choice D is wrong because they are not preferred over insulin injections for their ease of use and convenience.Insulin injections are still the gold standard for treating GDM, especially in cases of severe hyperglycemia or when oral drugs fail to achieve adequate glycemic control.Insulin injections also have fewer side effects and interactions than oral drugs.