BC ADM Gestational & Pregestational Diabetes Management 3

Question 1

When should postpartum glucose testing be performed in women who had gestational diabetes, and which test is recommended?

Accepted Answer

75g OGTT at 4-12 weeks postpartum (ideally 6-8 weeks)

Answer

ADA recommends a 75g OGTT at 4-12 weeks postpartum to screen for persistent dysglycemia; HbA1c is less sensitive early postpartum due to hematologic changes from delivery.

Question 2

What is the approximate lifetime risk of developing type 2 diabetes in women with a history of gestational diabetes?

Accepted Answer

Up to 50-70% over their lifetime

Answer

Women with prior GDM have up to 50-70% lifetime risk of developing type 2 diabetes, making ongoing surveillance and preventive intervention critically important.

Question 3

Which intervention has the strongest evidence for preventing or delaying progression from prediabetes (in women with prior GDM) to type 2 diabetes?

Accepted Answer

Intensive lifestyle intervention achieving 5-7% weight loss through diet and exercise

Answer

The Diabetes Prevention Program demonstrated that intensive lifestyle intervention (5-7% weight loss, 150 min/week physical activity) reduced T2DM progression by 58% in high-risk individuals, outperforming metformin.

Question 4

Women with pregestational type 1 diabetes planning pregnancy should be counseled that which microvascular complication may worsen during pregnancy?

Accepted Answer

Diabetic retinopathy, particularly with rapid early-pregnancy glycemic improvement

Answer

Diabetic retinopathy can paradoxically worsen when glycemic control improves rapidly at the start of pregnancy; preconception ophthalmologic evaluation and trimester-by-trimester monitoring are recommended.

Question 5

What HbA1c target is recommended prior to conception in women with pregestational diabetes to minimize congenital malformation risk?

Accepted Answer

Less than 6.5% if achievable without significant hypoglycemia risk

Answer

ADA recommends preconception HbA1c <6.5% if achievable without excessive hypoglycemia, as congenital malformation risk rises with HbA1c above this threshold during organogenesis.

(BC ADM) Advanced Diabetes Management Certification Practice Test

(BC ADM) Advanced Diabetes Management Certification Practice Test

BC ADM Gestational & Pregestational Diabetes Management 3