A nurse is teaching a pregnant woman who has gestational diabetes about the benefits of exercise during pregnancy.

The nurse should explain that exercise can help the woman by doing which of the following?

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 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.