A client with gestational diabetes asks the nurse about the role of exercise in managing blood sugar levels.

The nurse explains that exercise can help lower blood sugar levels and improve insulin sensitivity.

How many minutes of moderate physical activity per day is recommended for this client, unless advised otherwise by a healthcare provider?

The correct answer is choice A. Insulin injections.Insulin is the preferred medication for controlling blood sugar levels in gestational diabetes because it does not cross the placenta and affect the baby.Insulin lowers blood glucose by stimulating glucose uptake in muscle and fat cells and inhibiting glucose production in the liver.

Choice B.Metformin is wrong because metformin is an oral antidiabetic drug that can cross the placenta and may have unknown effects on the baby.Metformin works by decreasing glucose production in the liver and increasing insulin sensitivity in muscle and fat cells.

Choice C.Glyburide is wrong because glyburide is another oral antidiabetic drug that can cross the placenta and may cause hypoglycemia or other adverse effects in the baby.Glyburide works by stimulating insulin secretion from the pancreas and increasing insulin sensitivity in peripheral tissues.

Choice D.Oral corticosteroids are wrong because oral corticosteroids are not used to treat gestational diabetes, but rather to accelerate fetal lung maturation in preterm labor.Oral corticosteroids can actually increase blood glucose levels by stimulating gluconeogenesis and decreasing insulin sensitivity.

The correct answer is choice D.Exercise can help the woman by enhancing her insulin sensitivity and glucose utilization.

This means that her body can use the glucose in her blood more efficiently and lower her blood sugar levels.Exercise can also help prevent excess weight gain, which is a risk factor for gestational diabetes.

Choice A is wrong because exercise does not increase appetite and caloric intake, but rather helps regulate them.

Choice B is wrong because exercise does not lower blood pressure and heart rate, but rather increases them temporarily during physical activity.Choice C is wrong because exercise does not reduce the risk of preterm labor and delivery, but rather may increase it if done excessively or without proper supervision.