Explanation

insulin therapy is the most appropriate choice for managing blood sugar levels in a pregnant woman with elevated levels

Insulin does not cross the placenta, making it a safe option for both the mother and the developing fetus

Additional information:

Acarbose: Acarbose is not commonly used during pregnancy due to limited safety data.

Biguanides: Although metformin (a biguanide) has been used in some cases of gestational diabetes

Sulfonylureas: Sulfonylureas are generally avoided during pregnancy due to the risk of hypoglycemia.