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Gestational diabetes risk — DRCOG MCQ

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HardAntenatal CareGestational diabetes riskDRCOG

At 29 weeks, a woman with gestational diabetes has followed diet and exercise advice for 2 weeks, but her glucose readings remain above target. Her fasting glucose at diagnosis was 5.8 mmol/L. Which treatment should now be offered?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: B — Metformin alongside diet and physical activity

The best answer is “Metformin alongside diet and physical activity”. For gestational diabetes with fasting glucose below 7 mmol/L at diagnosis, NICE recommends a trial of diet and exercise changes. If targets are not met within 1 to 2 weeks, metformin should be offered; insulin is used if metformin is unsuitable or if control remains inadequate.

Reference: NICE NG3: Diabetes in pregnancy: https://www.nice.org.uk/guidance/ng3/chapter/recommendations