Which medication is the first choice for a pregnant woman with newly diagnosed IFG and an A1C of 5.9%?

Metformin is considered the first-line medication for a pregnant woman with newly diagnosed Impaired Fasting Glucose (IFG) and an A1C of 5.9%. This preference stems from several factors.

First, Metformin has a well-established safety profile during pregnancy. Studies have demonstrated that it is not associated with teratogenic effects, making it a suitable choice for managing glucose levels in pregnant patients. It effectively lowers blood glucose levels without causing significant hypoglycemia, which can be a concern when treating diabetes.

Second, Metformin is particularly beneficial for managing insulin resistance, which is common during pregnancy. It works primarily by decreasing hepatic glucose production and improving insulin sensitivity, which can help in reducing the risk of gestational diabetes.

While the other medications listed might be effective in managing diabetes, they come with potential complications or are less preferred during pregnancy. For instance, glipizide, a sulfonylurea, can increase the risk of hypoglycemia, which poses a risk to both the mother and the fetus. Liraglutide is a GLP-1 receptor agonist that is not typically recommended during pregnancy due to insufficient safety data. Sitagliptin, a DPP-4 inhibitor, also lacks enough