What is the pharmacologic treatment of choice for gestational diabetes?

The pharmacologic treatment of choice for gestational diabetes is regular insulin. This is due to its effectiveness in managing blood glucose levels without affecting fetal development negatively. Insulin is a peptide hormone that does not cross the placenta, making it safe for use in pregnancy.

In cases of gestational diabetes, the body is unable to produce enough insulin to maintain normal blood glucose levels due to the hormonal changes that occur during pregnancy. For this reason, administering exogenous insulin helps regulate the mother's blood sugar levels and reduces the risk of complications for both the mother and the fetus.

While oral hypoglycemic agents can be considered in some cases, insulin is preferred, particularly in more severe cases or when blood glucose levels are not sufficiently controlled with diet and lifestyle changes alone. Oral corticosteroids and glucagon are not appropriate treatments for gestational diabetes; corticosteroids can actually increase blood sugar levels, while glucagon is used to treat severe hypoglycemia, a condition not usually associated with gestational diabetes.