A patient diagnosed with mild gestational diabetes at 26 weeks is controlled with diet for 4 weeks but has rising fasting glucose values approaching diagnostic thresholds. What is the next reasonable monitoring or management step?

• A. Recommend a prolonged fast of 72 hours to reset maternal insulin sensitivity before any further testing or treatment decisions are made.
• B. Immediately schedule elective delivery at 28 weeks because any rise in fasting glucose mandates preterm delivery as the only safe option.
• C. Increase glucose monitoring frequency and consider initiating pharmacologic therapy (e.g., insulin) if repeated home fasting or postprandial values exceed targets despite diet and exercise.
• D. Stop all glucose monitoring because diet control failed briefly and pharmacologic therapy cannot be given in pregnancy.

Answer: (C)