BC ADM Gestational & Pregestational Diabetes Management

Question 1

What is the recommended two-step screening approach for gestational diabetes mellitus (GDM) at 24-28 weeks?

Accepted Answer

50g glucose challenge test; if ≥140 mg/dL, proceed to 3-hour 100g OGTT

Answer

The two-step approach uses a non-fasting 50g GCT at 24-28 weeks; a 1-hour result ≥140 mg/dL triggers the diagnostic 3-hour 100g OGTT.

Question 2

Using Carpenter-Coustan criteria for the 3-hour 100g OGTT, how many abnormal values are required to diagnose GDM?

Accepted Answer

2 or more values meeting threshold

Answer

GDM is diagnosed when 2 or more of the 4 timed values (fasting, 1-hr, 2-hr, 3-hr) meet or exceed the Carpenter-Coustan thresholds.

Question 3

Which glucose thresholds define GDM diagnosis using the one-step 75g OGTT (IADPSG/ADA criteria)?

Accepted Answer

Fasting ≥92, 1-hr ≥180, or 2-hr ≥153 mg/dL (any one value)

Answer

The IADPSG one-step 75g OGTT diagnoses GDM when any single value meets or exceeds fasting ≥92, 1-hr ≥180, or 2-hr ≥153 mg/dL.

Question 4

What is the primary pathophysiologic mechanism underlying gestational diabetes mellitus?

Accepted Answer

Insulin resistance amplified by placental hormones combined with inadequate beta-cell compensation

Answer

GDM results from physiologic pregnancy-related insulin resistance—amplified by placental hormones such as human placental lactogen—combined with insufficient compensatory beta-cell insulin secretion.

Question 5

Which of the following is NOT a recognized risk factor for gestational diabetes mellitus?

Accepted Answer

Nulliparity (no prior pregnancies)

Answer

Nulliparity is not a recognized risk factor for GDM; major risk factors include obesity, prior macrosomic infant, family history of T2DM, prior GDM, and certain ethnic backgrounds.

(BC ADM) Advanced Diabetes Management Certification Practice Test

(BC ADM) Advanced Diabetes Management Certification Practice Test

BC ADM Gestational & Pregestational Diabetes Management