Diabetes Education Certification Pregnancy & Gestational Diabetes 1 — Questions and Answers
Question 1: At what gestational week is universal screening for gestational diabetes mellitus (GDM) typically recommended?
- 8–12 weeks
- 14–18 weeks
- 24–28 weeks (Correct answer)
- 32–36 weeks
Correct answer: 24–28 weeks
Universal GDM screening is performed at 24–28 weeks gestation when placental hormones peak and cause maximal insulin resistance.
Question 2: Which test is used in the one-step approach to GDM screening recommended by the IADPSG?
- 50g glucose challenge test (non-fasting)
- Fasting plasma glucose alone
- 75g oral glucose tolerance test (OGTT) (Correct answer)
- Hemoglobin A1C
Correct answer: 75g oral glucose tolerance test (OGTT)
The IADPSG one-step approach uses a 75g OGTT with plasma glucose measured fasting, at 1 hour, and at 2 hours.
Question 3: What is the IADPSG fasting plasma glucose threshold for diagnosing gestational diabetes?
- 85 mg/dL
- 90 mg/dL
- 92 mg/dL (Correct answer)
- 100 mg/dL
Correct answer: 92 mg/dL
The IADPSG diagnostic criterion for GDM is a fasting plasma glucose ≥92 mg/dL, which is lower than the traditional ADA threshold.
Question 4: Poorly controlled GDM most directly causes which fetal complication?
- Placenta previa
- Macrosomia (Correct answer)
- Oligohydramnios
- Neural tube defects
Correct answer: Macrosomia
Maternal hyperglycemia causes fetal hyperinsulinemia, promoting excessive fat and glycogen deposition that results in macrosomia.
Question 5: What is the ADA-recommended fasting blood glucose target for women with gestational diabetes?
- <95 mg/dL (Correct answer)
- <105 mg/dL
- <110 mg/dL
- <120 mg/dL
Correct answer: <95 mg/dL
ADA recommends a fasting glucose of <95 mg/dL in GDM to reduce the risk of macrosomia and other perinatal complications.
Question 6: Women who have had gestational diabetes have an increased lifetime risk of developing which condition?
- Type 1 diabetes mellitus
- Type 2 diabetes mellitus (Correct answer)
- LADA (latent autoimmune diabetes in adults)
- Maturity-onset diabetes of the young (MODY)
Correct answer: Type 2 diabetes mellitus
Women with a history of GDM have a 35–60% lifetime risk of developing type 2 diabetes, reflecting underlying insulin resistance.
Question 7: Which long-acting insulin has the strongest evidence supporting its safety and efficacy as a basal insulin during pregnancy?
- Insulin glargine U-100
- Insulin detemir (Correct answer)
- Insulin degludec
- Insulin glargine U-300
Correct answer: Insulin detemir
Insulin detemir (Levemir) has the most robust randomized trial data supporting its safety and efficacy for basal insulin therapy during pregnancy.
Diabetes Education Certification Pregnancy & Gestational Diabetes 1
At what gestational week is universal screening for gestational diabetes mellitus (GDM) typically recommended?