Question 1

Normal pregnancy, without diabetes, is characterized by progressive insulin resistance, maternal hyperinsulinemia, and mild postprandial hyperglycemia.

Accepted Answer

During a normal pregnancy, hormonal changes lead to increased insulin resistance, causing the pancreas to produce more insulin (hyperinsulinemia) to maintain normal blood glucose levels, resulting in mild postprandial hyperglycemia.

Question 2

Which of the following placental hormones has the greatest effect of increasing insulin resistance:

Accepted Answer

E

Question 3

Gestational diabetes is not associated with which of the following:

Accepted Answer

Gestational diabetes is associated with hyperglycemia in the mother, but it typically leads to hypoglycemia in the newborn due to the baby's pancreas producing extra insulin.

Question 4

B.C. is a 37-year-old G1 P0 at 8 weeks gestation with a BMI of 25 and no known family history of diabetes. She is of Southeast Asian descent. According to American Diabetes Association/American College of Obstetricians and Gynecologists guidelines should she be screened now for GDM?

Accepted Answer

According to the American Diabetes Association/American College of Obstetricians and Gynecologists guidelines, all pregnant women should be screened for GDM, regardless of their risk factors.

Question 5

R.S. underwent a one-step, 2-hour oral glucose tolerance test (OGTT) at 26 weeks. Which of the following results diagnose GDM?

Accepted Answer

The answer of R.S. underwent a one-step, 2-hour oral glucose...

Question 6

Healthy eating is the cornerstone of successful diabetes management. Which of the following does not constitute healthy eating during pregnancy with GDM?

Accepted Answer

Cutting out carbohydrates is not recommended as they are essential for energy. Instead, managing carbohydrate intake and choosing complex carbohydrates is advised.

Question 7

L.L. has GDM and has been following the meal plan provided by the registered dietician and her fasting values have been 95mg/dL, 92mg/dL, 85 mg/dL, 99mg/dL 85 mg/dL, 86mg/dL, and 98mg/dL. Postmeal values are 142mg/dL; 146mg/dL; 149mg/dL,152C; 143mg/dL150mg/dL. What advice would you give her?

Accepted Answer

The fasting blood glucose levels are mostly within the target range for gestational diabetes, but the postmeal values are consistently above the recommended target of 140 mg/dL. This suggests that dietary management alone is not sufficient, and starting medication or insulin may be necessary to achieve better glucose control.

Question 8

M.M. has GDMA1 and gets her blood glucose (BG) checked weekly at her clinic appointment. She wants to know why she also needs to check her BG four times every day. Which of the following is true regarding her question?

Accepted Answer

Checking BG four times daily prevents ketonuria and reflex hypoglycemia and improves food choices. Studies show that women who checked their BG four times daily by a home monitor had less macrosomia than women who had their BG checked weekly.

Question 9

Women with diabetes during pregnancy are at increased risk for depression and should be screened for depression and referred appropriately.

Accepted Answer

Women with diabetes during pregnancy are at a higher risk for developing depression due to the physical and emotional challenges associated with managing both conditions, and screening can help in providing timely support and intervention.

Question 10

S.R. has GDM. She loves to eat white rice with each meal but changed to brown rice and reduced her intake to one cup at dinner to keep her blood glucose in control. This is successful problem solving. What other strategies would exemplify successful problem solving?

Accepted Answer

The answer of S.R. has GDM. She loves to eat...

Question 11

D.B. is 36 weeks pregnant and has GDMA1 and no other complications. She usually has one or two mildly elevated postprandial blood sugars each week. Which of the following would be a part of your management?

Accepted Answer

For a woman with GDMA1 (gestational diabetes managed with diet alone) and no other complications, management typically involves awaiting labor as you would for a woman without GDM, as long as blood sugar levels are mostly controlled and there are no other risk factors.

Question 12

M.M is currently 32 weeks pregnant and has GDM. She requires medication because her fasting blood glucose levels have been consistently elevated. She does not want the medicine to go to the baby. Which medication would you suggest?

Accepted Answer

Insulin is the preferred medication for managing gestational diabetes mellitus (GDM) when medication is necessary, as it does not cross the placenta and therefore does not affect the baby.

Question 13

Evidence shows which of the following to reduce the risk of future diabetes for a woman who has GDM?

Accepted Answer

Breastfeeding for at least 6 months has been shown to reduce the risk of developing type 2 diabetes in women who had gestational diabetes mellitus (GDM).

Question 14

Which of the following is true of women who have GDM?

Accepted Answer

The answer of Which of the following is true of...

Question 15

In addition to assuming a healthy lifestyle, how can a woman with GDMA2 know if diabetes is in her future?

Accepted Answer

A 2-hour OGTT 6-12 weeks postpartum and regular diabetes checks every 1-3 years can help monitor and assess the risk of developing diabetes in the future.

Quiz 33: Gestational Diabetes Mellitus