<prompt> A 30-year-old G3P2 obese woman at 26 weeks gestation with no significant past medical history states that diabetes runs in her family. Her other pregnancies were uncomplicated. The results of a 3-hour glucose tolerance test show the following glucose levels: 0 fasting: 90 mgdL 1 hour: 195 mgdL 2 hours: 155 mgdL 3 hours: 145 mgdLAs a result, she is diagnosed with gestational diabetes. She is counselled to start diet modification and exercise to control her glycemic levels. 3 weeks after her diagnosis, she presents her values: Fasting: 95 mgdL 1 hr pp: 185 mgdLWhat is the best management?Continue diet modificationStart insulinRepeat GTTStart metformin  <response>: Ans. is b, i.e. Start insulinRef. Dutta Obs. 7e, p 285In the question patients GTT showedFasting 90mgdL upper limit 95mgdL, i.e. normal1 hour pp 195mgdL upper limit 180mgdL, i.e. abnormal2 hour pp 155mgdL upper limit 155, i.e. normal3 hour pp 145mgdL upper limit 140, i.e. abnormalThus 2 values are abnormal, i.e. patient is a confirmed case of gestational diabetes.As indicated, she was put on diet modification for 3 weeks and after 3 weeks, herFasting value 95mgdL2 hour postprandial 180mgdLRemember: Metabolic goals of diabetes areFasting 95mgdL2hourPP 120mgdLIf these goals are not achieved by diet alone, insulin should be started. 