A woman diagnosed with gestational diabetes remains hyperglycemic after diet and exercise. What is the least appropriate treatment option?

In the case of a woman diagnosed with gestational diabetes who continues to have high blood sugar levels despite diet and exercise interventions, the least appropriate treatment option would be the use of an SGLT2 inhibitor. This class of medication is commonly utilized in the management of type 2 diabetes, as they work by promoting the excretion of glucose through the urine and lowering blood sugar levels. However, their use is generally contraindicated during pregnancy, including in cases of gestational diabetes, due to potential risks to both the mother and the fetus.

The other treatment options, including insulin injections, may be necessary when dietary changes and exercise alone are not sufficient to control blood glucose levels. Insulin is safe and effective for managing blood sugar levels in pregnant women. Sulfonylureas are oral hypoglycemic agents that can be considered as well, although they are less commonly used than insulin during pregnancy because of the potential for fetal safety concerns.

Dietary supplements can also play a role, especially those that help to manage overall nutrition and support the health of the pregnant woman and her developing baby, although they should be used under the guidance of a healthcare provider. Therefore, considering the safety profile and appropriateness in the context of gestational diabetes, the SGL