In this case, the nurse should prioritize insulin therapy for the risk of miscarriage and birth defects is the highest with increase glucose levels. The glycated hemoglobin or hemoglobin A1C that is >8 percent or the average blood glucose is >180 mg/dL is an indication of increase glucose level.
In addition, glucose in the mother's blood will cross in the placenta to provide energy for the baby but would result to high blood glucose levels in the developing baby as well, which is critical and should be address immediately.